Microarray-based analysis of ventilator-induced lung injury.
Microarray-based analysis of ventilator-induced lung injury.
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DOI：
10.1513/pats.200608-149jg
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Wurfel, Mark M
中科院分区：
文献类型：
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作者：
Wurfel, Mark M
急性呼吸窘迫综合征（ARDS）和急性肺损伤（ALI）是重症监护病房入院的常见原因，在美国每年影响超过200，000名患者。在ARDS和ALI的情况下，机械通气是一种挽救生命的干预措施，但临床试验表明，潮气量过大的机械通气在促进和维持肺损伤方面发挥作用，并导致死亡率过高。这一过程被称为呼吸机诱导的肺损伤（VILI），但驱动这一过程的分子机制及其与败血症和化学损伤等易感风险因素的相互作用仍不完全清楚。使用微阵列技术的基因表达的全基因组测量代表了检查VILI的病理生理学的有力工具。最近的几项研究已经使用这种方法来研究孤立的VILI和与内毒素滴注或盐水灌洗相关的VILI。这些研究和其他研究在上皮细胞的基因表达谱进行周期性拉伸提供了新的见解VILI的分子机制。本文将总结这些发现并讨论对未来研究的影响。
Acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) are a frequent cause of intensive care unit admission, affecting over 200,000 patients in the United States each year. Mechanical ventilation is a life-saving intervention in the setting of ARDS and ALI, but clinical trials have demonstrated that mechanical ventilation with excessive tidal volumes plays a role in promoting and perpetuating lung injury and leads to excess mortality. This process has been labeled ventilator-induced lung injury (VILI), but the molecular mechanisms driving this process and its interactions with predisposing risk factors such as sepsis and chemical injury remain incompletely understood. Genome-wide measurements of gene expression using microarray technology represent a powerful tool to examine the pathophysiology of VILI. Several recent studies have used this approach to study VILI in isolation and associated with endotoxin instillation or saline lavage. These studies and others examining gene expression profiles in epithelial cells subjected to cyclic stretch have provided novel insights on the molecular mechanisms underlying VILI. This review will summarize these findings and discuss implications for future studies.