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Mechanisms of Hypoxic Pulmonary Vasoconstriction

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Hypoxic pulmonary vasoconstriction (HPV) is an essential mechanism of the lung which matches blood perfusion to alveolar ventilation. Under conditions of regional alveolar hypoxia, HPV reduces blood flow to poorly ventilated and thus hypoxic lung regions, thereby optimising gas exchange. HPV can also be termed “normoxic pulmonary vasodilatation”, as HPV is activated after birth when alveolar ventilation is initiated. Disturbances in vasorelaxation after birth may contribute to development of persistent pulmonary hypertension of the newborn (PPHN).

HPV ’s underlying mechanisms have not been fully elucidated yet. At the level of oxygen sensors, reactive oxygen species (ROS)-producing systems like mitochondria and NADPH oxidases have been proposed, with some controversy. Voltage-dependent potassium channels (Kv-channels) and transient receptor potential channels (TRPC) have also been shown to be essential.

A better understanding of these would allow us to treat dysregulated HPV , the resulting hypoxaemia and also PPHN .

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