Therapeutic approach to vascular remodelling in asthma.

Bronchial asthma can be characterized by some significant changes in airway blood vessels, which may contribute to airway remodelling. Despite the clinical and functional consequences of bronchial microvascular remodelling in asthma, up to now, little data have been published on the therapeutic approach to this phenomenon. Corticosteroids are the only anti-asthma drugs that act positively on the three aspects of bronchial vascular remodelling: angiogenesis, dilatation and permeability. Modest positive effects of treatments with beta2-agonists and leukotrienes receptor antagonists on bronchial microcirculatory changes have been reported. In the future, agents that specifically inhibit angiogenesis could represent a novel approach for positively acting on bronchial microvascular changes in chronic inflammatory airway diseases, such as chronic bronchitis and asthma.