Cytokine-mediated inflammation in acute lung injury.
Clinical acute lung injury (ALI) is a major cause of acute respiratory failure in critically ill patients. There is considerable experimental and clinical evidence that pro- and anti-inflammatory cytokines play a major role in the pathogenesis of inflammatory-induced lung injury from sepsis, pneumonia, aspiration, and shock. A recent multi-center clinical trial found that a lung-protective ventilatory strategy reduces mortality by 22% in patients with ALI. Interestingly, this protective ventilatory strategy was associated with a marked reduction in the number of neutrophils and the concentration of pro-inflammatory cytokines released into the airspaces of the injured lung. Further research is needed to establish the contribution of cytokines to both the pathogenesis and resolution of ALI.
Goodman
Richard B
RB
Medical Research Service, Department of Veterans Affairs, VA Puget Sound Health Care System, VA Puget Sound Medical Center, Division of Pulmonary & Critical Care, University of Washington School of Medicine, Seattle, WA 98108, USA.
Pugin
Jérôme
J
Lee
Janet S
JS
Matthay
Michael A
MA
D000818:Animals; D018925:Chemokines / Q000378:metabolism; D002630:Chemotactic Factors / Q000378:metabolism; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000096:biosynthesis* / Q000378:metabolism; D004487:Edema / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D024243:HMGB1 Protein / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D007375:Interleukin-1 / Q000378:metabolism; D016753:Interleukin-10 / Q000378:metabolism; D016209:Interleukin-8 / Q000276:immunology; D008024:Ligands; D008168:Lung / Q000276:immunology; D055370:Lung Injury; D008263:Macrophage Migration-Inhibitory Factors / Q000378:metabolism; D008954:Models, Biological; D015337:Multicenter Studies as Topic; D009504:Neutrophils / Q000378:metabolism; D012128:Respiratory Distress Syndrome / Q000276:immunology* / Q000378:metabolism; D013997:Time Factors
D018925:Chemokines; D002630:Chemotactic Factors; D016207:Cytokines; D024243:HMGB1 Protein; D007375:Interleukin-1; D016209:Interleukin-8; D008024:Ligands; D008263:Macrophage Migration-Inhibitory Factors; D016753:Interleukin-10