Lung tissue remodeling in the acute respiratory distress syndrome
AUTOR(ES)
Souza, Alba Barros de, Santos, Flavia Brandão dos, Negri, Elnara Marcia, Zin, Walter Araujo, Rocco, Patricia Rieken Macedo
FONTE
Jornal de Pneumologia
DATA DE PUBLICAÇÃO
2003-08
RESUMO
Acute respiratory distress syndrome (ARDS) is characterized by diffuse alveolar damage, and evolves progressively with three phases: exsudative, fibroproliferative, and fibrotic. In the exudative phase, there are interstitial and alveolar edemas with hyaline membrane. The fibroproliferative phase is characterized by exudate organization and fibroelastogenesis. There is proliferation of type II pneumocytes to cover the damaged epithelial surface, followed by differentiation into type I pneumocytes. The fibroproliferative phase starts early, and its severity is related to the patient’s prognosis. The alterations observed in the phenotype of the pulmonary parenchyma cells steer the tissue remodeling towards either progressive fibrosis or the restoration of normal alveolar architecture. The fibrotic phase is characterized by abnormal and excessive deposition of extracellular matrix proteins, mainly collagen. The dynamic control of collagen deposition and degradation is regulated by metalloproteinases and their tissular regulators. The deposition of proteoglycans in the extracellular matrix of ARDS patients needs better study. The regulation of extracellular matrix remodeling, in normal conditions or in several pulmonary diseases, such as ARDS, results from a complex mechanism that integrate the transcription of elements that destroy the matrix protein and produce activation/inhibition of several cellular types of lung tissue. This review article will analyze the ECM organization in ARDS, the different pulmonary parenchyma remodeling mechanisms, and the role of cytokines in the regulation of the different matrix components during the remodeling process.
Documentos Relacionados
- Acute Lung Injury. Pathogenesis of adult respiratory distress syndrome
- Heterotopic brain tissue in the lung causing acute respiratory distress in an infant.
- Acute respiratory distress syndrome
- Corticosteroids in acute respiratory distress syndrome
- Lung Tissue Elastin Composition in Newborn Infants with the Respiratory Distress Syndrome and Other Diseases