1. Impaired Lung Function and Risk for Stroke
Tamagawa Eiji , MD, PhD, van Eeden Stephan F. , MD, PhD 
CHEST 
Volume 130, Issue 6, Pages (December 2006)
DOI: /chest
Copyright © 2006 The American College of Chest Physicians Terms and Conditions

2. Figure 1
Pathways that potentially explain how lung inflammation can trigger acute vascular events such as heart attacks and stroke. Lung inflammation due to COPD, asthma, infection, or exposure to air pollution results in a systemic inflammatory response with increases in the levels of circulating leukocytes, platelets, cytokines, and acute-phase proteins. These mediators activate the vascular endothelium, causing endothelial dysfunction that is characterized by reduced vasodilatation with decreases in nitric oxide (NO), increases in endothelin (ET) expression, and increases in vascular permeability and the uptake of oxidized low-density lipoproteins (LDLs) into atherosclerotic plaques. Collectively, these events destabilize plaque by the up-regulation of adhesion molecules with accelerated leukocyte recruitment, increase foam cell formation and the recruitment of smooth muscle cells, release and activate proteases that degrade the extracellular matrix and destabilize plaques, making them vulnerable for rupture. MMP = matrix metalloprotein; TNF = tumor necrosis factor; ROS = reactive oxygen species.
CHEST  , DOI: ( /chest )
Copyright © 2006 The American College of Chest Physicians Terms and Conditions