A Razor's Edge: Vascular Responses to Acute Inflammatory Lung Injury/Acute Respiratory Distress Syndrome

被引:10
作者
Price, David R. [1 ]
Garcia, Joe G. N. [2 ]
机构
[1] Weill Cornell Med Ctr, Div Pulm & Crit Care Med, Dept Med, New York Presbyterian Hosp, New York, NY USA
[2] Herbert Wertheim UF Scripps, Ctr Inflammat Sci & Syst Med, Inst Biomed Innovat & Technol, Jupiter, FL 33458 USA
基金
美国国家卫生研究院;
关键词
ARDS; acute respiratory distress syndrome; vascular responses; endothelium; innate immunity; cell death; inflammation; LIGHT-CHAIN-KINASE; COLONY-ENHANCING FACTOR; NF-KAPPA-B; MICROVASCULAR ENDOTHELIAL-CELLS; SPHINGOSINE; 1-PHOSPHATE; MECHANICAL-STRESS; CYTOSKELETAL REARRANGEMENT; SPHINGOSINE-1-PHOSPHATE RECEPTORS; EPIGENETIC REGULATION; BARRIER ENHANCEMENT;
D O I
10.1146/annurev-physiol-042222-030731
中图分类号
Q4 [生理学];
学科分类号
071003 ;
摘要
Historically considered a metabolically inert cellular layer separating the blood from the underlying tissue, the endothelium is now recognized as a highly dynamic, metabolically active tissue that is critical to organ homeostasis. Under homeostatic conditions, lung endothelial cells (ECs) in healthy subjects are quiescent, promoting vasodilation, platelet disaggregation, and anti-inflammatory mechanisms. In contrast, lung ECs are essential contributors to the pathobiology of acute respiratory distress syndrome (ARDS), as the quiescent endothelium is rapidly and radically altered upon exposure to environmental stressors, infectious pathogens, or endogenous danger signals into an effective and formidable regulator of innate and adaptive immunity. These dramatic perturbations, produced in a tsunami of inflammatory cascade activation, result in paracellular gap formation between lung ECs, sustained lung edema, and multi-organ dysfunction that drives ARDS mortality. The astonishing plasticity of the lung endothelium in negotiating this inflammatory environment and efforts to therapeutically target the aberrant ARDS endothelium are examined in further detail in this review.
引用
收藏
页码:505 / 529
页数:25
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