TY - JOUR T1 - The ROS controversy in hypoxic pulmonary hypertension revisited JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00276-2018 VL - 51 IS - 3 SP - 1800276 AU - Sébastien Bonnet AU - Olivier Boucherat Y1 - 2018/03/01 UR - http://erj.ersjournals.com/content/51/3/1800276.abstract N2 - Hypoxic pulmonary vasoconstriction (HPV) is a local and adaptive response to alveolar hypoxia causing constriction of small pulmonary arteries, thereby reducing perfusion to underventilated alveoli. However, in pathological conditions characterised by global and persistent hypoxia, such as chronic obstructive pulmonary disease (COPD), this physiological mechanism that normally serves to optimise ventilation–perfusion matching become damaging, promoting sustained pulmonary vasoconstriction and vascular remodelling [1]. These structural changes are accompanied by a gradual increase of pulmonary arterial pressure, ultimately leading to right ventricular (RV) hypertrophy and failure. Although there is a global consensus amongst scientists that elevation of the intracellular calcium concentration plays a critical role in producing HPV, the precise underlying mechanisms (e.g. nature of the oxygen sensor, direction of changes in reactive oxygen species (ROS) as well as how ROS production affects the activity of calcium channels) and even the cell type involved remain a subject of ongoing debate [2–4].A study published in the ERJ investigates the role of superoxide in adaptation of the pulmonary vasculature to chronic hypoxia and adaptation of the right ventricle to increased afterload http://ow.ly/Dj9Q30iwO8R ER -