Important characteristics of chronic obstructive pulmonary disease (COPD)
include airway and vascular remodeling, the molecular mechanisms of which
are poorly understood. We assessed the role of fibroblast growth factors
(FGF) in pulmonary vascular remodeling by examining the expression pattern
of FGF-1, FGF-2, and the FGF receptor (FGFR-1) in peripheral area of lung
tissues from patients with COPD (FEV(1) < or = 75%; n = 15) and without
COPD (FEV(1) > or = 85%; n = 13). Immunohistochemical staining results
were evaluated by digital video image analysis as well as by manual
scoring. FGF-1 and FGFR-1 were detected in vascular smooth muscle (VSM),
airway smooth muscle, and airway epithelial cells. FGF-2 was localized in
the cytoplasm of airway epithelium and in the nuclei of airway smooth
muscle, VSM, and endothelial cells. In COPD cases, an unequivocal increase
in FGF-2 expression was observed in VSM (3-fold, P = 0.001) and
endothelium (2-fold, P = 0.007) of small pulmonary vessels with a luminal
diameter under 200 micro m. In addition, FGFR-1 levels were elevated in
the intima (1.5-fold, P = 0.05). VSM cells of large (> 200 micro m)
pulmonary vessels showed increased staining for FGF-1 (1.6-fold, P < 0.03)
and FGFR-1 (1.4-fold, P < 0.04) in COPD. Pulmonary vascular remodeling,
assessed as the ratio of alpha-smooth muscle actin staining and vascular
wall area with the lumen diameter, was increased in large vessels of
patients with COPD (P = 0.007) and was inversely correlated with FEV(1)
values (P < 0.007). Our results suggest an autocrine role of the
FGF-FGFR-1 system in the pathogenesis of COPD-associated vascular
remodeling