The endothelium in acute lung injury/acute respiratory distress syndrome.
OBJECTIVE
Since pulmonary edema from increased endothelial permeability is the hallmark of acute lung injury, a frequently encountered entity in critical care medicine, the study of endothelial responses in this setting is crucial to the development of effective endothelial-targeted treatments.


RESULTS
From the enormous amount of research in the field of endothelial pathophysiology, we have focused on work delineating endothelial alterations elicited by noxious stimuli implicated in acute lung injury. The bulk of the material covered deals with molecular and cellular aspects of the pathogenesis, reflecting current trends in the published literature. We initially discuss pathways of endothelial dysfunction in acute lung injury and then cover the mechanisms of endothelial protection. Several experimental treatments in animal models are presented, which aid in the understanding of the disease pathogenesis and provide evidence for potentially useful therapies.


CONCLUSIONS
Mechanistic studies have delivered several interventions, which are effective in preventing and treating experimental acute lung injury and have thus provided objectives for translational studies. Some of these modalities may evolve into clinically useful tools in the treatment of this devastating illness.
Maniatis
Nikolaos A
NA
M. Simou Laboratory, University of Athens Medical School, Athens, Greece.
Orfanos
Stylianos E
SE
D042682:Angiopoietins / Q000378:metabolism; D000818:Animals; D003599:Cytoskeleton / Q000378:metabolism / Q000648:ultrastructure; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D011654:Pulmonary Edema / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D026361:Reactive Nitrogen Species / Q000378:metabolism; D017382:Reactive Oxygen Species / Q000378:metabolism; D012084:Renin-Angiotensin System / Q000502:physiology; D012128:Respiratory Distress Syndrome / Q000473:pathology / Q000503:physiopathology* / Q000517:prevention & control; D015398:Signal Transduction
D042682:Angiopoietins; D026361:Reactive Nitrogen Species; D017382:Reactive Oxygen Species