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Air Pollution and the Pulmonary Vasculature
Book chapter

Air Pollution and the Pulmonary Vasculature

Melissa L. Bates and Rebecca Bascom
Textbook of Pulmonary Vascular Disease, pp.963-977
Springer Nature
01/01/2011
DOI: 10.1007/978-0-387-87429-6_67

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Abstract

Particulate air pollution is associated with mortality of many cardiorespiratory disease. This implausible association, is now well supported by epidemiology studies, as is discussed in this chapter. There is now additional evidence for morbidity from asthma, COPD, ischemic heart disease, and congestive heart failure. We now know that ultrafine particles escape detection by the macrophage defense system and translocate to the circulation. We know that, in vitro, air pollution activates endothelin-1 (ET-1), a key regulator of the pulmonary circulation. The recommended chapter outline provided by the editors points to gaps in our knowledge: Sections on clinical manifestations, complications, diagnosis, treatment and prevention, and prognosis are meager because no coherent body of information yet exists. The fragmentary evidence presented herein is intriguing in its suggestion that common air pollutants target the pulmonary circulation and the right side of the heart. The data are by no means robust. A key purpose of this chapter is to challenge pulmonary vascular biologists and clinicians to reconsider the hypothesis that ambient air pollution causes or exacerbates pulmonary vascular disease. This chapter will discuss the effects of reactive gas and particulate pollution on the pulmonary circulation, creating a link between epidemiological findings in humans and experimental findings from controlled exposure studies in human and animal models. It will discuss the pulmonary circulation as a system directly affected by pollutants, as a point of entry into the systemic circulation, and as a biochemically active entity whose mediators exert both local and systemic effects after exposure.
Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology General & Internal Medicine Life Sciences & Biomedicine Medicine, General & Internal Science & Technology

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