Smouldering fire or conflagration? An illustrated update on the concept of inflammation in pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is a rare condition that is characterised by a progressive increase of pulmonary vascular resistances that leads to right ventricular failure and death, if untreated. The underlying narrowing of the pulmonary vasculature relies on several independent and interdependent biological pathways, such as genetic predisposition and epigenetic changes, imbalance of vasodilating and vasoconstrictive mediators, as well as dysimmunity and inflammation that will trigger endothelial dysfunction, smooth muscle cell proliferation, fibroblast activation and collagen deposition. Progressive constriction of the pulmonary vasculature, in turn, initiates and sustains hypertrophic and maladaptive myocardial remodelling of the right ventricle. In this review, we focus on the role of inflammation and dysimmunity in PAH which is generally accepted today, although existing PAH-specific medical therapies still lack targeted immune-modulating approaches.

  • Perros, F.
  • Humbert, M.
  • Dorfmüller, P.

Keywords

  • Familial Primary Pulmonary Hypertension
  • Heart Ventricles
  • Humans
  • Inflammation/diagnosis
  • *Pulmonary Arterial Hypertension
  • Pulmonary Artery
Publication details
DOI: 10.1183/16000617.0161-2021
Journal: Eur Respir Rev
Number: 162
Work Type: Review
Access number: 34937704
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