Angiogenesis and bronchial vascular remodelling in asthma and COPD

In the last years, growing attention has been focused on the vascular component of airway remodelling in chronic bronchial inflammation, such as asthma and COPD, and on its role in the progression of disease. In particular, in asthmatic subjects, the bronchial mucosa shows a larger number of vessels with higher dimension and a greater vascular area. Recently, insights have been obtained on the pivotal role of vascular endothelial growth factor (VEGF) in promoting vascular remodelling and angiogenesis. In fact, many studies conducted on biopsies, induced sputum or BAL, have shown the involvement of VEGF and of its receptors in the vascular remodelling processes. However, multiple mechanisms act in concert in chronic airway diseases, resulting in bronchial vascular remodelling, with a variety of growth factors and cytokines involved. Presumably, the vascular component of airway remodelling is a complex multi-step phenomenon engaging several mediators. The aim of this review was to analyze the morphological aspects of the vascular component of airway remodelling and the possible mechanisms involved in asthma and COPD