par De Troyer, André ;Derenne, Jean Ph;Yernault, Jean Claude
Référence Clinical Respiratory Physiology, 14, 6, page (785-800)
Publication Publié, 1978
Article révisé par les pairs
Résumé : Up to now respiratory physiologists have paid little attention to the functional disorders of the respiratory apparatus that are liable to arise during diseases which start at a distance from the lung. This lack of interest is no doubt related to the fact that the lung has long been considered a passive organ controlling gaseous exchanges whose own metabolism was negligible. Several recent studies, however, have reminded us that the development and function of the lung are affected by various hormones, including the growth hormone and thyroid hormones. This is a good opportunity to clarify the position in this field and to review the respiratory functional anomalies described in endocrine disorders. It must be emphasized that the published results are fragmentary and sometimes even contradictory: moreover, throughout this review the authors have tried to separate probabilities from uncertainties, while indicating the points which seem to deserve complementary investigations. It must also be emphasized that this work deals with endocrine disorders; in no way does it try to review the biochemical changes observed in experimental pathology through the action of certain hormones. Thus, there is no reference to the role of glucocorticoids in the maturation of the system which can produce surface acting agents, nor of the effects of the catecholamines on adenylcyclase, or of their part in the control of the tonus of the smooth muscle of the bronchi. In the same way, there is no attempt to define exactly the cellular activity of the different hormones. Lastly, the authors do not consider the reaction of respiratory failures or their treatment of the endocrine glands. The studies analysed in this review clearly show that the lung is not an inert organ but that its structure, and therefore its functioning, can be affected by general biochemical or metabolic changes, produced either by hormonal dysfunctions or other types of aggression. Another example of functional respiratory disorders produced by acute disorders arising outside the lung can be found in acute pancreatitis, even when there are no clinical or radiological signs of a pulmonary lesion. Moreover, the lung itself is only one stage in a complex system whose extrapulmonary components vary, as is illustrated by the complex anomalies induced by thyroid disorders. The time seems to have arrived for the respiratory physiologist to expand his routine fields of investigation to improve the definition of the place of the respiratory system in the general management of the organism.