Lung repair and remodeling after injury_West China Medical Journal

Authors：

 SONG Yuanlin ^1,2,3 , HOU Dongni ¹

1. Department of Pulmonary and Critical Care Medicine, Zhongshan Hosptial, Fudan University, Shanghai 200032, P. R. China;
2. Shanghai Key Laboratory of Lung Inflammation and Injury, Shanghai 200032, P. R. China;
3. Shanghai Institute of Major Infectious Diseases and Biosafety, Shanghai 200032, P. R. China;

Corresponding author：

SONG Yuanlin, Email: ylsong70@163.com

Keywords：

Inflammation; injury; repair; remodeling; chronic obstructive pulmonary disease; acute lung injury; acute respiratory distress syndrome

DOI：

10.7507/1002-0179.202112061

Video：

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Abstract Full text Figures/Tables Video References Cited by

Lung injury could be classified as acute and chronic injuries, such as acute respiratory distress syndrome and chronic obstructive pulmonary disease. Lung function recovery mainly depends on inflammation adjusting, lung and airway remodeling, endogenous stem cell proliferation and differentiation, and tissue repair. The principles of clinical therapy include inhibition of inflammation, balancing coagulation and fibrinolysis, and protective lung ventilation for acute lung injury; while reduction of hyper-secretion, bronchodilation, adjusting airway mucosal inflammation and immunity, as well as improving airway remodeling for chronic obstructive pulmonary disease. The functional recovery of lung and airway depends on endogenous stem cell proliferation and repair. The purpose of clinical treatment is to provide assistance for lung and airway repair besides pathophysiological improvement.

Citation： SONG Yuanlin, HOU Dongni. Lung repair and remodeling after injury. West China Medical Journal, 2022, 37(1): 8-11. doi: 10.7507/1002-0179.202112061 Copy

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2.	Huppert LA, Matthay M, Ware LB. Pathogenesis of acute respiratory distress syndrome. Semin Respir Crit Care Med, 2019, 40(1): 31-39.
3.	Griffiths MJD, McAuley DF, Perkins GD, et al. Guidelines on the management of acute respiratory distress syndrome. BMJ Open Respir Res, 2019, 6(1): e000420.
4.	Labaki WW, Rosenberg SR. Chronic obstructive pulmonary disease. Ann Intern Med, 2020, 173(3): ITC17-ITC32.
5.	Bagdonas E, Raudoniute J, Bruzauskaite I, et al. Novel aspects of pathogenesis and regeneration mechanisms in COPD. Int J Chron Obstruct Pulmon Dis, 2015, 10: 995-1013.
6.	Borthwick DW, Shahbazian M, Krantz QT, et al. Evidence for stem-cell niches in the tracheal epithelium. Am J Respir Cell Mol Biol, 2001, 24(6): 662-670.
7.	Deeb RS, Walters MS, Strulovici-Barel Y, et al. Smoking-associated disordering of the airway basal stem/progenitor cell metabotype. Am J Respir Cell Mol Biol, 2016, 54(2): 231-240.
8.	Tse HN, Raiteri L, Wong KY, et al. High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study. Chest, 2013, 144(1): 106-118.
9.	Akram KM, Patel N, Spiteri MA, et al. Lung regeneration: endogenous and exogenous stem cell mediated therapeutic approaches. Int J Mol Sci, 2016, 17(1): 128.
10.	Parekh KR, Nawroth J, Pai A, et al. Stem cells and lung regeneration. Am J Physiol Cell Physiol, 2020, 319(4): C675-C693.
11.	Fan E, Brodie D, Slutsky AS. Acute respiratory distress syndrome advances in diagnosis and treatment. JAMA, 2018, 319(7): 698-710.
12.	Wu C, Hou D, Du C, et al. Corticosteroid therapy for coronavirus disease 2019-related acute respiratory distress syndrome: a cohort study with propensity score analysis. Crit Care, 2020, 24(1): 643.
13.	Fang F, Zhang Y, Tang J, et al. Association of corticosteroid treatment with outcomes in adult patients with sepsis: a systematic review and meta-analysis. JAMA Intern Med, 2019, 179(2): 213-223.
14.	Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood, 2020, 135(23): 2033-2040.
15.	Chen X, Chen Y, Wu C, et al. Coagulopathy is a major extrapulmonary risk factor for mortality in hospitalized patients with COVID-19 with type 2 diabetes. BMJ Open Diabetes Res Care, 2020, 8(2): e001851.
16.	Wang L, Shi M, Tong L, et al. Lung-resident mesenchymal stem cells promote repair of LPS-induced acute lung injury via regulating the balance of regulatory T cells and Th17 cells. Inflammation, 2019, 42(1): 199-210.
17.	Cheng T, Feng Y, Chen X, et al. Lung-resident mesenchymal stem cells regulated the inflammatory responses in innate and adaptive immune cells through HVEM-BTLA pathway during ARDS. Exp Cell Res, 2020, 395(1): 112155.
18.	Rabe KF, Watz H. Chronic obstructive pulmonary disease. Lancet, 2017, 389(10082): 1931-1940.
19.	Shi J, Li H, Yuan C, et al. Cigarette smoke-induced acquired dysfunction of cystic fibrosis transmembrane conductance regulator in the pathogenesis of chronic obstructive pulmonary disease. Oxid Med Cell Longev, 2018, 2018: 6567578.
20.	Van Eeden SF, Hogg JC. Immune-modulation in chronic obstructive pulmonary disease: current concepts and future strategies. Respiration, 2020, 99(7): 550-565.
21.	Su X, Wang L, Song Y, et al. Inhibition of inflammatory responses by ambroxol, a mucolytic agent, in a murine model of acute lung injury induced by lipopolysaccharide. Intensive Care Med, 2004, 30(1): 133-140.
22.	Yan X, Song Y, Shen C, et al. Mucoactive and antioxidant medicines for COPD: consensus of a group of Chinese pulmonary physicians. Int J Chron Obstruct Pulmon Dis, 2017, 12: 803-812.
23.	Rabe KF, Martinez FJ, Ferguson GT, et al. Triple inhaled therapy at two glucocorticoid doses in moderate-to-very-severe COPD. N Engl J Med, 2020, 383(1): 35-48.
24.	Forbes SJ, Rosenthal N. Preparing the ground for tissue regeneration: from mechanism to therapy. Nat Med, 2014, 20(8): 857-869.
25.	McDonald VM, Fingleton J, Agusti A, et al. Treatable traits: a new paradigm for 21st century management of chronic airway diseases: Treatable Traits Down Under International Workshop report. Eur Respir J, 2019, 53(5): 1802058.

1. Matthay M, Song Y, Bai C, et al. The acute respiratory distress syndrome in 2013. Transl Respir Med, 2013, 1(1): 10.
2. Huppert LA, Matthay M, Ware LB. Pathogenesis of acute respiratory distress syndrome. Semin Respir Crit Care Med, 2019, 40(1): 31-39.
3. Griffiths MJD, McAuley DF, Perkins GD, et al. Guidelines on the management of acute respiratory distress syndrome. BMJ Open Respir Res, 2019, 6(1): e000420.
4. Labaki WW, Rosenberg SR. Chronic obstructive pulmonary disease. Ann Intern Med, 2020, 173(3): ITC17-ITC32.
5. Bagdonas E, Raudoniute J, Bruzauskaite I, et al. Novel aspects of pathogenesis and regeneration mechanisms in COPD. Int J Chron Obstruct Pulmon Dis, 2015, 10: 995-1013.
6. Borthwick DW, Shahbazian M, Krantz QT, et al. Evidence for stem-cell niches in the tracheal epithelium. Am J Respir Cell Mol Biol, 2001, 24(6): 662-670.
7. Deeb RS, Walters MS, Strulovici-Barel Y, et al. Smoking-associated disordering of the airway basal stem/progenitor cell metabotype. Am J Respir Cell Mol Biol, 2016, 54(2): 231-240.
8. Tse HN, Raiteri L, Wong KY, et al. High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study. Chest, 2013, 144(1): 106-118.
9. Akram KM, Patel N, Spiteri MA, et al. Lung regeneration: endogenous and exogenous stem cell mediated therapeutic approaches. Int J Mol Sci, 2016, 17(1): 128.
10. Parekh KR, Nawroth J, Pai A, et al. Stem cells and lung regeneration. Am J Physiol Cell Physiol, 2020, 319(4): C675-C693.
11. Fan E, Brodie D, Slutsky AS. Acute respiratory distress syndrome advances in diagnosis and treatment. JAMA, 2018, 319(7): 698-710.
12. Wu C, Hou D, Du C, et al. Corticosteroid therapy for coronavirus disease 2019-related acute respiratory distress syndrome: a cohort study with propensity score analysis. Crit Care, 2020, 24(1): 643.
13. Fang F, Zhang Y, Tang J, et al. Association of corticosteroid treatment with outcomes in adult patients with sepsis: a systematic review and meta-analysis. JAMA Intern Med, 2019, 179(2): 213-223.
14. Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood, 2020, 135(23): 2033-2040.
15. Chen X, Chen Y, Wu C, et al. Coagulopathy is a major extrapulmonary risk factor for mortality in hospitalized patients with COVID-19 with type 2 diabetes. BMJ Open Diabetes Res Care, 2020, 8(2): e001851.
16. Wang L, Shi M, Tong L, et al. Lung-resident mesenchymal stem cells promote repair of LPS-induced acute lung injury via regulating the balance of regulatory T cells and Th17 cells. Inflammation, 2019, 42(1): 199-210.
17. Cheng T, Feng Y, Chen X, et al. Lung-resident mesenchymal stem cells regulated the inflammatory responses in innate and adaptive immune cells through HVEM-BTLA pathway during ARDS. Exp Cell Res, 2020, 395(1): 112155.
18. Rabe KF, Watz H. Chronic obstructive pulmonary disease. Lancet, 2017, 389(10082): 1931-1940.
19. Shi J, Li H, Yuan C, et al. Cigarette smoke-induced acquired dysfunction of cystic fibrosis transmembrane conductance regulator in the pathogenesis of chronic obstructive pulmonary disease. Oxid Med Cell Longev, 2018, 2018: 6567578.
20. Van Eeden SF, Hogg JC. Immune-modulation in chronic obstructive pulmonary disease: current concepts and future strategies. Respiration, 2020, 99(7): 550-565.
21. Su X, Wang L, Song Y, et al. Inhibition of inflammatory responses by ambroxol, a mucolytic agent, in a murine model of acute lung injury induced by lipopolysaccharide. Intensive Care Med, 2004, 30(1): 133-140.
22. Yan X, Song Y, Shen C, et al. Mucoactive and antioxidant medicines for COPD: consensus of a group of Chinese pulmonary physicians. Int J Chron Obstruct Pulmon Dis, 2017, 12: 803-812.
23. Rabe KF, Martinez FJ, Ferguson GT, et al. Triple inhaled therapy at two glucocorticoid doses in moderate-to-very-severe COPD. N Engl J Med, 2020, 383(1): 35-48.
24. Forbes SJ, Rosenthal N. Preparing the ground for tissue regeneration: from mechanism to therapy. Nat Med, 2014, 20(8): 857-869.
25. McDonald VM, Fingleton J, Agusti A, et al. Treatable traits: a new paradigm for 21st century management of chronic airway diseases: Treatable Traits Down Under International Workshop report. Eur Respir J, 2019, 53(5): 1802058.

West China Medical Journal

Lung repair and remodeling after injury

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