Pathophysiological Approaches of Acute Respiratory Distress syndrome: Novel Bases for Study of Lung Injury



R.L Castillo*, 1, R Carrasco Loza 2, C Romero-Dapueto 3
1 Programa de Fisiopatología, Facultad de Medicina, Universidad de Chile, Chile
2 Departamento de Medicina, Hospital del Salvador, Santiago, Chile; Laboratorio de Investigación Biomédica, Hospital del Salvador, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
3 Servicio de Medicina Física y Rehabilitación, Clínica Alemana de Santiago, Santiago, Chile


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© Castillo et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile. Independencia 1027, 8380453, Santiago, Chile; Tel/Fax: 56-2-9786943; E-mail: rcastillo@med.uchile.cl


Abstract

Experimental approaches have been implemented to research the lung damage related-mechanism. These models show in animals pathophysiological events for acute respiratory distress syndrome (ARDS), such as neutrophil activation, reactive oxygen species burst, pulmonary vascular hypertension, exudative edema, and other events associated with organ dysfunction. Moreover, these approaches have not reproduced the clinical features of lung damage. Lung inflammation is a relevant event in the develop of ARDS as component of the host immune response to various stimuli, such as cytokines, antigens and endotoxins. In patients surviving at the local inflammatory states, transition from injury to resolution is an active mechanism regulated by the immuno-inflammatory signaling pathways. Indeed, inflammatory process is regulated by the dynamics of cell populations that migrate to the lung, such as neutrophils and on the other hand, the role of the modulation of transcription factors and reactive oxygen species (ROS) sources, such as nuclear factor kappaB and NADPH oxidase. These experimental animal models reproduce key components of the injury and resolution phases of human ALI/ARDS and provide a methodology to explore mechanisms and potential new therapies.

Keywords: ALI/ARDS, animal models, inflammation, neutrophils, reactive oxygen species.