Endothelins and the lung

Since endothelins were discovered by Yanasigawa in 1988 it has been re cogn ised that they may have an important role in-lung pathophysiology. Despite their biological importance as vasoconstrictors the physiological role of e ndothelin has not yet been defined within the lungs. This review explores t heir role in acute and chronic disease. During acute inflammation and ischa emia-reperfusion injury cytokines may induce release of endothelin. This is important in the realm of acute lung injury and during surgical procedures such as cardiopulmonary operations including::lung resections and transpla ntation. Complications of surgery including primary organ failure resulting in poor gas exchange as well as increased pulmonary vascular resistance ha ve been linked to the presence of excessive endothelin. Endothelin may have an important role in transplantation biology. The complex process leading to successful lung transplantation includes optimising the donor with brain death, harvesting the lungs, managing acute and chronic rejection, and pro tecting the vital organs from toxic effects of immunosuppressants. During c hronic disease processes, the mitotic action of endothelin may be important : in vascular and airway remodelling by means of smooth muscle cell prolife ration. We also explore recent advances in drug development, animal models and future directions for research. (C) 1999 Elsevier Science Ltd. All righ ts reserved.