Inflammatory profiling in chronic lung disease

Chronic lung diseases (CLD), such as chronic obstructive pulmonary disease (COPD) and idiopathic pulmonary fibrosis (IPF) are increasing cause of death in the aging population. Symptoms include chronic dyspnoea, cough, fatigue and weight loss, which all contribute to a poor quality of life. CLD are often complicated by the presence of pulmonary hypertension (PH), where even a mild elevation of blood pressure in the pulmonary arteries is associated with an even poorer prognosis. Vascular remodelling underlies all forms of PH and directly contributes to the increased pulmonary pressure. Despite several therapeutic options being available for the idiopathic form of PH they only decrease the symptoms and delay clinical worsening and do not address the underlying causes. To date there are no medications available for the treatment of PH associated with CLD. Inflammation plays an important role in mediating vascular remodelling in idiopathic form of PH. Where the accumulation of inflammatory cells in and around the vascular wall correlates with the degree of vascular remodelling. These recruited cells release soluble mediators that directly induce vascular remodelling processes, and can induce a chronic inflammatory state by recruiting further inflammatory cells. Despite this knowledge, very little is known about the role of inflammation in PH associated with CLD. In this study, we will determine whether similarities exist in the inflammatory profile that could potentially underlie all forms of PH and determine its relationship to vascular remodelling. Furthermore, by examining isolated inflammatory cells, we determine how they can regulate vascular remodelling processes. This study will not only further our understanding of these deadly diseases, but also form the basis of strategies that can used for new immune-modulatory therapeutic approaches.