Alveolar epithelium and Na,K-ATPase in acute lung injury

• Published in: Intensive care medicine Vol. 33; no. 7; pp. 1243 - 1251
• Main Authors: VADASZ, Istvan, RAVIV, Stacy, SZNAJDER, Jacob I
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.07.2007; Berlin Springer Nature B.V; Springer Berlin Heidelberg
• Subjects: Adenosine triphosphatase; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Edema; Emergency and intensive respiratory care; Epithelium - enzymology; Extravascular Lung Water - metabolism; Humans; Injuries of the thorax. Foreign bodies. Diseases due to physical agents; Intensive care medicine; Lungs; Medical sciences; Mini-series: basic research-related topics in ICM; Proteins; Pulmonary Alveoli - enzymology; Pulmonary Edema - metabolism; Respiratory Distress Syndrome, Adult - drug therapy; Respiratory Distress Syndrome, Adult - enzymology; Signal Transduction; Sodium; Sodium-Potassium-Exchanging ATPase - metabolism; Traumas. Diseases due to physical agents; Edema; Acute lung injury; Oxygen; Intensive care; Dopamine; Respiratory disease; Enzyme; Edema clearance, Hypoxia,Coagulation; K; Catecholamine; Epithelium; Na; Neurotransmitter; Hydrolases; Hypoxia; exchanging ATPase; Resuscitation; Catecholamines,Dopamine; Protein trafficking
• ISSN: 0342-4642; 1432-1238
• DOI: 10.1007/s00134-007-0661-8

Active transport of sodium across the alveolar epithelium, undertaken in part by the Na,K-adenosine triphosphatase (Na,K-ATPase), is critical for clearance of pulmonary edema fluid and thus the outcome of patients with acute lung injury. Acute lung injury results in disruption of the alveolar epithelial barrier and leads to impaired clearance of edema fluid and altered Na,K-ATPase function. There has been significant progress in the understanding of mechanisms regulating alveolar edema clearance and signaling pathways modulating Na,K-ATPase function during lung injury. The accompanying review by Morty et al. focuses on intact organ and animal models as well as clinical studies assessing alveolar fluid reabsorption in alveolar epithelial injury. Elucidation of the mechanisms underlying regulation of active Na+ transport, as well as the pathways by which the Na,K-ATPase regulates epithelial barrier function and edema clearance, are of significance to identify interventional targets to improve outcomes of patients with acute lung injury.