BACKGROUND: The time course and mechanisms of resolution and repair, and the potential for fibrosis following ventilation-induced lung injury (VILI), are unclear. We sought to examine the pattern of inflammation, injury, repair, and fibrosis following VILI. METHODS: Sixty anesthetized rats were subject to high-stretch; low-stretch, or sham ventilation, and randomly allocated to undergo periods of recovery of 6, 24, 48, and 96 h, and 7 and 14 days. Animals were then reanesthetized, and the extent of lung injury, inflammation, and repair determined. RESULTS: No injury was seen following low-stretch or sham ventilation. VILI caused severe lung injury, maximal at 24 h, but largely resolved by 96 h. Arterial oxygen tension decreased from a mean (SD) of 144.8 (4.1) mmHg to 96.2 (10.3) mmHg 6 h after VILI, before gradually recovering to 131.2 (14.3) mmHg at 96 h. VILI induced an early neutrophilic alveolitis and a later lymphocytic alveolitis, followed by a monocyte/macrophage infiltration. Alveolar tumor necrosis factor-α, interleukin-1β, and transforming growth factor-β1 concentrations peaked at 6 h and returned to baseline within 24 h, while interleukin-10 remained increased for 48 h. VILI generated a marked but transient fibroproliferative response, which restored normal lung architecture. There was no evidence of fibrosis at 7 and 14 days. CONCLUSIONS: High-stretch ventilation caused severe lung injury, activating a transient inflammatory and fibroproliferative repair response, which restored normal lung architecture without evidence of fibrosis.
BACKGROUND: The time course and mechanisms of resolution and repair, and the potential for fibrosis following ventilation-induced lung injury (VILI), are unclear. We sought to examine the pattern of inflammation, injury, repair, and fibrosis following VILI. METHODS: Sixty anesthetized rats were subject to high-stretch; low-stretch, or sham ventilation, and randomly allocated to undergo periods of recovery of 6, 24, 48, and 96 h, and 7 and 14 days. Animals were then reanesthetized, and the extent of lung injury, inflammation, and repair determined. RESULTS: No injury was seen following low-stretch or sham ventilation. VILI caused severe lung injury, maximal at 24 h, but largely resolved by 96 h. Arterial oxygen tension decreased from a mean (SD) of 144.8 (4.1) mmHg to 96.2 (10.3) mmHg 6 h after VILI, before gradually recovering to 131.2 (14.3) mmHg at 96 h. VILI induced an early neutrophilic alveolitis and a later lymphocytic alveolitis, followed by a monocyte/macrophage infiltration. Alveolar tumor necrosis factor-α, interleukin-1β, and transforming growth factor-β1 concentrations peaked at 6 h and returned to baseline within 24 h, while interleukin-10 remained increased for 48 h. VILI generated a marked but transient fibroproliferative response, which restored normal lung architecture. There was no evidence of fibrosis at 7 and 14 days. CONCLUSIONS: High-stretch ventilation caused severe lung injury, activating a transient inflammatory and fibroproliferative repair response, which restored normal lung architecture without evidence of fibrosis.
Authors: Nuria E Cabrera-Benitez; John G Laffey; Matteo Parotto; Peter M Spieth; Jesús Villar; Haibo Zhang; Arthur S Slutsky Journal: Anesthesiology Date: 2014-07 Impact factor: 7.892
Authors: Yi Xin; Kevin Martin; Caio C A Morais; Paolo Delvecchio; Sarah E Gerard; Hooman Hamedani; Jacob Herrmann; Nicholas Abate; Austin Lenart; Shiraz Humayun; Uday Sidhu; Mihail Petrov; Kristan Reutlinger; Tal Mandelbaum; Ian Duncan; Nicholas Tustison; Stephen Kadlecek; Shampa Chatterjee; James C Gee; Rahim R Rizi; Lorenzo Berra; Maurizio Cereda Journal: Crit Care Med Date: 2021-10-01 Impact factor: 9.296
Authors: Mairead Hayes; Gerard F Curley; Claire Masterson; James Devaney; Daniel O'Toole; John G Laffey Journal: Intensive Care Med Exp Date: 2015-10-15
Authors: D F McAuley; G F Curley; U I Hamid; J G Laffey; J Abbott; D H McKenna; X Fang; M A Matthay; J W Lee Journal: Am J Physiol Lung Cell Mol Physiol Date: 2014-02-14 Impact factor: 5.464