HIV-related pulmonary arterial hypertension (PAH) is one of the long-term complications of HIV infection that has become increasingly apparent in recent years. The clinical presentation and underlying pathology of PAH in HIV is similar to that in other forms of the disease, although there are data to suggest subtle differences, such as a greater inflammatory component in the HIV-related form. Advances continue to be made in defining the underlying pathogenesis of PAH, but the overall processes leading to vascular dysfunction and remodeling remain unclear. It would appear that PAH has a multifactorial etiology, with various risk factors--probably acting on an underlying genetic predisposition--that lead to the pulmonary vascular dysfunction that characterizes the disease. A range of growth factors, chemokines, cytokines and other inflammatory mediators, together with mediators involved in vasoconstriction and dilation, have been implicated in the pulmonary vascular remodeling resulting from this dysfunction. An increased understanding of the processes and factors involved in PAH has led to the development of new therapeutic strategies that have improved the management of various forms of PAH, including PAH associated with HIV (HIV-PAH). Recent results from studies into other potential mediators of PAH offer the possibility of new targets for therapy in this progressive and serious condition.

译文

HIV相关的肺动脉高压 (PAH) 是HIV感染的长期并发症之一,近年来日益明显。HIV中PAH的临床表现和潜在病理与其他形式的疾病相似,尽管有数据表明存在细微差异,例如HIV相关形式中的炎症成分更大。在定义PAH的潜在发病机理方面继续取得进展,但导致血管功能障碍和重塑的总体过程尚不清楚。看来,PAH具有多因素病因,具有各种危险因素-可能作用于潜在的遗传易感性-导致该疾病的肺血管功能障碍。一系列生长因子,趋化因子,细胞因子和其他炎症介质,以及参与血管收缩和扩张的介质,都与这种功能障碍导致的肺血管重塑有关。对PAH所涉及的过程和因素的日益了解导致了新的治疗策略的发展,这些治疗策略改善了各种形式的PAH的管理,包括与HIV相关的PAH (HIV-PAH)。对PAH其他潜在介质的研究的最新结果为这种进行性和严重疾病的治疗提供了新的靶标。

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