Figure 1–
Effects of inhaled corticosteroids (ICS) on blood vessels and progression of atherosclerosis. ICS can downregulate the inflammatory process in the lungs, which in turn, reduces the spillover of inflammatory mediators from the lungs into the systemic circulation, dampening the systemic inflammatory process that is persistent in patients with obstructive airways disease. Because systemic inflammation is a co-factor in the genesis of endothelial dysfunction and progression of atherosclerosis, ICS can enhance blood vessel function and reduce the risk of ischaemic events. Critical to this process are mediators such as interleukin (IL)-6, tumour necrosis factor (TNF)-α, matrix metalloproteinases (MMPs) and nitric oxide, which may be modulated by ICS. CRP: C-reactive protein; ET-1: endothelin-1; ICAM-1: intercellular adhesion molecule-1; oxLDL: oxidised low-density lipoprotein; ROS: reactive oxygen species; VCAM-1: vascular cell adhesion molecule-1.