Pathogenesis of pneumonia and acute lung injury.
Pathogenesis of pneumonia and acute lung injury.
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DOI：
10.1042/cs20210879
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发表时间：
2022-05-27
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肺炎及其后遗症，即急性肺损伤，给肺部和重症监护医护人员带来了独特的挑战，由于持续的Sars-CoV-2大流行，这些挑战最近引起了全球的关注。急性肺损伤，包括其最严重的表现（急性呼吸窘迫综合征，ARDS）的转化研究的一个限制是临床和生理诊断的异质性，这代表了各种各样的病因。最近的努力通过定义ARDS的亚表型提高了我们对异质性的理解和方法，尽管在知识方面仍然存在重大差距。提高我们对急性肺损伤及其最常见原因感染性肺炎的机制理解，可以推进我们的方法来精确靶向临床干预。在这里，我们回顾了肺炎和急性肺损伤的发病机制，包括呼吸道感染和肺损伤是如何破坏肺内平衡的，并概述了呼吸道微生物的发病机制、肺微生物组，以及在人体临床试验中已被证明可以改善或不能改善结果的干预措施。
Pneumonia and its sequelae, acute lung injury, present unique challenges for pulmonary and critical care healthcare professionals, and these challenges have recently garnered global attention due to the ongoing Sars-CoV-2 pandemic. One limitation to translational investigation of acute lung injury, including its most severe manifestation (acute respiratory distress syndrome, ARDS) has been heterogeneity resulting from the clinical and physiologic diagnosis that represents a wide variety of etiologies. Recent efforts have improved our understanding and approach to heterogeneity by defining sub-phenotypes of ARDS although significant gaps in knowledge remain. Improving our mechanistic understanding of acute lung injury and its most common cause, infectious pneumonia, can advance our approach to precision targeted clinical interventions. Here, we review the pathogenesis of pneumonia and acute lung injury, including how respiratory infections and lung injury disrupt lung homoeostasis, and provide an overview of respiratory microbial pathogenesis, the lung microbiome, and interventions that have been demonstrated to improve outcomes—or not—in human clinical trials.
DOI：
10.1136/ejhpharm-2020-002507
发表时间：
2022-05
期刊：
European journal of hospital pharmacy : science and practice
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