PURPOSE: Recent studies suggest a role for distal airway injury in acute respiratory distress syndrome (ARDS). The epithelium lining the small airways secretes a large number of molecules such as surfactant components and inflammatory mediators. There is little information on how these small airway secretory functions are altered in ARDS. MATERIALS AND METHODS: We studied the lungs of 31 patients with ARDS (Pao(2)/fraction of inspired oxygen ≤200, 45 ± 14 years, 16 men) and 11 controls (52 ± 16 years, 7 men) submitted to autopsy and quantified the expression of interleukin (IL) 6, IL-8, surfactant proteins (SP) A and SP-B in the epithelium of small airways using immunohistochemistry and image analysis. In addition, an index of airway epithelial apoptosis was determined by the terminal deoxynucleotidyl transferase-mediated deoxyuridine-triphosphatase nick-end labeling assay, caspase 3, and Fas/Fas ligand expression. The density of inflammatory cells expressing IL-6 and IL-8 within the small airway walls was also quantified. RESULTS: Acute respiratory distress syndrome airways showed an increase in the epithelial expression of IL-8 (P = .006) and an increased density of inflammatory cells expressing IL-6 (P = .004) and IL-8 (P < .001) compared with controls. There were no differences in SP-A and SP-B epithelium expression or in epithelial apoptosis index between ARDS and controls. CONCLUSION: Distal airways are involved in ARDS lung inflammation and show a high expression of proinflammatory interleukins in both airway epithelial and inflammatory cells. Apoptosis may not be a major mechanism of airway epithelial cell death in ARDS.
PURPOSE: Recent studies suggest a role for distal airway injury in acute respiratory distress syndrome (ARDS). The epithelium lining the small airways secretes a large number of molecules such as surfactant components and inflammatory mediators. There is little information on how these small airway secretory functions are altered in ARDS. MATERIALS AND METHODS: We studied the lungs of 31 patients with ARDS (Pao(2)/fraction of inspired oxygen ≤200, 45 ± 14 years, 16 men) and 11 controls (52 ± 16 years, 7 men) submitted to autopsy and quantified the expression of interleukin (IL) 6, IL-8, surfactant proteins (SP) A and SP-B in the epithelium of small airways using immunohistochemistry and image analysis. In addition, an index of airway epithelial apoptosis was determined by the terminal deoxynucleotidyl transferase-mediated deoxyuridine-triphosphatase nick-end labeling assay, caspase 3, and Fas/Fas ligand expression. The density of inflammatory cells expressing IL-6 and IL-8 within the small airway walls was also quantified. RESULTS: Acute respiratory distress syndrome airways showed an increase in the epithelial expression of IL-8 (P = .006) and an increased density of inflammatory cells expressing IL-6 (P = .004) and IL-8 (P < .001) compared with controls. There were no differences in SP-A and SP-B epithelium expression or in epithelial apoptosis index between ARDS and controls. CONCLUSION: Distal airways are involved in ARDS lung inflammation and show a high expression of proinflammatory interleukins in both airway epithelial and inflammatory cells. Apoptosis may not be a major mechanism of airway epithelial cell death in ARDS.
Authors: R J Shah; J M Diamond; E Cantu; J Flesch; J C Lee; D J Lederer; V N Lama; J Orens; A Weinacker; D S Wilkes; D Roe; S Bhorade; K M Wille; L B Ware; S M Palmer; M Crespo; E Demissie; J Sonnet; A Shah; S M Kawut; S L Bellamy; A R Localio; J D Christie Journal: Am J Transplant Date: 2015-04-15 Impact factor: 8.086
Authors: R J Shah; N Wickersham; D J Lederer; S M Palmer; E Cantu; J M Diamond; S M Kawut; V N Lama; S Bhorade; M Crespo; E Demissie; J Sonett; K Wille; J Orens; A Weinacker; P Shah; S Arcasoy; D S Wilkes; J D Christie; L B Ware Journal: Am J Transplant Date: 2014-01-08 Impact factor: 8.086
Authors: Cristiane Beatriz de Oliveira; Cídia Vasconcellos; Neusa Y Sakai-Valente; Mirian Nacagami Sotto; Fernanda Guedes Luiz; Walter Belda Júnior; Maria da Gloria Teixeira de Sousa; Gil Benard; Paulo Ricardo Criado Journal: Rev Inst Med Trop Sao Paulo Date: 2015 Jan-Feb Impact factor: 1.846