New Insights into the Alveolar Epithelium as a Driver of Acute Respiratory Distress Syndrome

Biomolecules. 2022 Sep 10;12(9):1273. doi: 10.3390/biom12091273.

Abstract

The alveolar epithelium serves as a barrier between the body and the external environment. To maintain efficient gas exchange, the alveolar epithelium has evolved to withstand and rapidly respond to an assortment of inhaled, injury-inducing stimuli. However, alveolar damage can lead to loss of alveolar fluid barrier function and exuberant, non-resolving inflammation that manifests clinically as acute respiratory distress syndrome (ARDS). This review discusses recent discoveries related to mechanisms of alveolar homeostasis, injury, repair, and regeneration, with a contemporary emphasis on virus-induced lung injury. In addition, we address new insights into how the alveolar epithelium coordinates injury-induced lung inflammation and review maladaptive lung responses to alveolar damage that drive ARDS and pathologic lung remodeling.

Keywords: ARDS; alveolar epithelium; lung regeneration; lung remodeling; lung repair.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Epithelium
  • Humans
  • Lung / pathology
  • Lung Injury* / pathology
  • Respiratory Distress Syndrome*
  • Respiratory Mucosa