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

• Published in: Biomolecules (Basel, Switzerland) Vol. 12; no. 9; p. 1273
• Main Authors: Sanches Santos Rizzo Zuttion, Marilia, Moore, Sarah Kathryn Littlehale, Chen, Peter, Beppu, Andrew Kota, Hook, Jaime Lynn
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.09.2022; MDPI
• Subjects: Acute respiratory distress syndrome; alveolar epithelium; Alveoli; ARDS; Causes of; Coronaviruses; COVID-19; Disease transmission; Edema; Endothelium; Epithelium; Gas exchange; Health aspects; Homeostasis; Humans; Infections; Inflammation; Lung - pathology; Lung Injury - pathology; lung regeneration; lung remodeling; lung repair; Lungs; Pandemics; Pathogenesis; Pathogens; Permeability; Physiological aspects; Proteins; Pulmonary alveoli; Respiratory Distress Syndrome; Respiratory Mucosa; Review; Severe acute respiratory syndrome coronavirus 2; Surfactants; United States; alveolar epithelium; lung remodeling; lung repair; ARDS; lung regeneration
• ISSN: 2218-273X; 2218-273X
• DOI: 10.3390/biom12091273

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.