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Erschienen in: Intensive Care Medicine 4/2008

01.04.2008 | Mini Series: Basic research-related topics in ICM

Advances in mechanisms of repair and remodelling in acute lung injury

verfasst von: Claudia C. Dos Santos

Erschienen in: Intensive Care Medicine | Ausgabe 4/2008

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Abstract

Background

Acute respiratory distress syndrome (ARDS) is the most severe manifestation of acute lung injury (ALI). In patients who survive the acute injury the process of repair and remodelling may be an independent risk factor determining morbidity and mortality. This review explores recent advances in the field of fibroproliferative ARDS/ALI, with a special emphasis on (a) the primary contributing factors with a focus on cellular and soluble factors, and (b) mechanisms involved in repair and remodelling as they pertain to the importance of cell death, re-population, and matrix deposition.

Discussion

Factors influencing progression to fibroproliferative ARDS vs. resolution and reconstitution of the normal pulmonary parenchymal architecture are poorly understood. Determinants of persistent injury and abnormal repair and remodelling may be profoundly affected by both environmental and genetic factors. Moreover, cumulative evidence suggests that acute inflammation and fibrosis may be in part independent and interactive processes that are autonomously regulated and thus amenable to individual and specific therapy.

Conclusions

Although our current understanding of these processes is limited by the inability to accurately replicate the complex human physiology in laboratory settings, it has recently become apparent that the process of repair and remodelling begins early in the course of ARDS/ALI and may be determined by the type of pulmonary injury. Understanding the mechanisms leading to and regulating fibroproliferative changes may contribute to the development of novel early therapeutic interventions in ARDS/ALI patients.
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Metadaten
Titel
Advances in mechanisms of repair and remodelling in acute lung injury
verfasst von
Claudia C. Dos Santos
Publikationsdatum
01.04.2008
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 4/2008
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-007-0963-x

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