Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 148, Boston, MA 02114, USA.
Clin Chest Med. 2024 Dec;45(4):821-833. doi: 10.1016/j.ccm.2024.08.004. Epub 2024 Sep 20.
The alveolar-capillary barrier includes microvascular endothelial and alveolar epithelial cells and their matrices, and its disruption is a critical driver of lung injury during development of acute respiratory distress syndrome. In this review, we provide an overview of the structure and function of the alveolar-capillary barrier during health and highlight several important signaling mechanisms that underlie endothelial and epithelial injury during critical illness, emphasizing areas with potential for development of therapeutic strategies targeting alveolar-capillary leak. We also emphasize the importance of biomarker and preclinical studies in developing novel therapies and highlight important areas warranting future investigation.
肺泡毛细血管屏障包括微血管内皮细胞和肺泡上皮细胞及其基质,其破坏是急性呼吸窘迫综合征发展过程中肺损伤的关键驱动因素。在这篇综述中,我们概述了健康状态下肺泡毛细血管屏障的结构和功能,并强调了几个重要的信号机制,这些机制是危重病期间内皮和上皮损伤的基础,强调了针对肺泡毛细血管渗漏开发治疗策略的潜在领域。我们还强调了在开发新疗法方面进行生物标志物和临床前研究的重要性,并强调了值得进一步研究的重要领域。