Biomedical Engineering Reference
In-Depth Information
10
Inflammatory Mediators
Peter J. Barnes
National Heart and Lung Institute, Imperial College, London, U.K.
I.
INTRODUCTION
While many inflammatory mediators have been identified in asthma (1,2),
there is much less information about the production and role of mediators
in COPD. The COPD is a complex inflammatory disease that involves many
different types of inflammatory and structural cells, all of which have the
capacity to release multiple inflammatory mediators (Fig. 1). This suggests
that mediator antagonists may have some potential as new therapies for
COPD. of the redundant effects of many inflammatory mediators it, unli-
kely that antagonists of a single mediator, will provide major clinical benefit,
as is the case in asthma. There is much less information available about the
mediators of COPD than those of asthma. Unlike asthma, some patients
with COPD also have systemic features of the disease and these are also
likely to be mediated via inflammatory mediators.
II.
LIPID MEDIATORS
As in asthma, lipid mediators derived from arachidonic acid may play an
important role in the pathophysiology of COPD.
A. Prostaglandins
There is an increase in the concentration of prostaglandin(PG) E
2
in exhaled
breath of COPD patients (3) (Fig. 2). This is likely to be derived from
cyclooxygenase-2 (COX-2), which is expressed in alveolar macrophages
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