Airway wall |
Contraction of airway smooth muscle |
Impairment of β‐adrenoceptor function |
Stimulation of airway secretion |
Pulmonary vascular smooth muscle |
relaxation or contraction |
Activation of mast cells |
Alveolar epithelial cell layer |
Increased permeability by detachment |
Decreased adherence |
Increased cell lysis |
Lung matrix |
Decreased elastin synthesis and fragmentation |
Decreased collagen synthesis and fragmentation |
Depolymerisation of proteoglycans |
Antiproteases |
Inactivation of α1‐proteinase inhibitor |
Inactivation of secretory leukoprotease inhibitor |
Pulmonary microcirculation |
Increased permeability |
PMN sequestration |
Increased PMN adhesion to endothelium of arterioles and venules |
Transcription factors |
Switch-on of TNF‐α, IL‐8 and other inflammatory protein genes |
PMN: polymorphonuclear neutrophil
TNF‐α: tumour necrosis factor‐α
IL: interleukin
Modified from 6, 7