A diversified approach to investigate the mechanism of acute lung injury and to establish its therapeutic strategy

我们发现，促炎细胞因子分泌在非通气肺在单肺通气，而这些细胞因子减少时，持续气道正压通气（CPAP）应用于非通气肺。 在单肺通气时对非通气肺应用CPAP是预防术后肺损伤的一种方法，可推广应用于急性呼吸窘迫综合征（ARDS）的呼吸机策略。 高呼气末正压（PEEP）的应用不仅有利于改善动脉血氧分压，而且可以通过防止肺组织缺氧来减轻肺部炎症和伴随的肺损伤。 此外，我们发现缺氧诱导因子（HIF）-1减少炎症，典型的TNF-α上调实验低氧血症在体内和体外。 提示激活HIF-1可能成为肺损伤治疗的一个潜在途径。

We found that pro-inflammatory cytokines are secreted in non-ventilated lungs during one-lung ventilation, while these cytokines were reduced when continuous positive airway pressure (CPAP) was applied in the non-ventilated lungs. Application of CPAP to non-ventilated lungs during one-lung ventilation would be a prophylactic approach for post-operative lung injury.These concepts may be generalized to ventilator strategies during acute respiratory distress syndrome (ARDS). The application of high positive end-expiratory pressure (PEEP) would be of benefit not only to improve arterial partial oxygen tension but also to ameliorate lung inflammation and concomitant lung injury by preventing lung tissue hypoxia. In addition, we found that hypoxia inducible factor (HIF)-1 reduces the inflammation, typical for TNF-alpha up-regulation during experimental hypoxemia in vivo and in vitro. It is suggested that activation of HIF-1 would be a potential therapeutic approach for lung injury.