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Review
. 2022 Nov 1;9(1):61.
doi: 10.1186/s40779-022-00417-9.

Extracellular vesicles in the pathogenesis and treatment of acute lung injury

Qian Hu #  1 , Shu Zhang #  2 , Yue Yang  1 , Jia-Qi Yao  1 , Wen-Fu Tang  1 , Christopher J Lyon  3   4 , Tony Ye Hu  5   6 , Mei-Hua Wan  7   8
Affiliations
Review

Extracellular vesicles in the pathogenesis and treatment of acute lung injury

Qian Hu et al. Mil Med Res. .

Abstract

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common life-threatening lung diseases associated with acute and severe inflammation. Both have high mortality rates, and despite decades of research on clinical ALI/ARDS, there are no effective therapeutic strategies. Disruption of alveolar-capillary barrier integrity or activation of inflammatory responses leads to lung inflammation and injury. Recently, studies on the role of extracellular vesicles (EVs) in regulating normal and pathophysiologic cell activities, including inflammation and injury responses, have attracted attention. Injured and dysfunctional cells often secrete EVs into serum or bronchoalveolar lavage fluid with altered cargoes, which can be used to diagnose and predict the development of ALI/ARDS. EVs secreted by mesenchymal stem cells can also attenuate inflammatory reactions associated with cell dysfunction and injury to preserve or restore cell function, and thereby promote cell proliferation and tissue regeneration. This review focuses on the roles of EVs in the pathogenesis of pulmonary inflammation, particularly ALI/ARDS.

Keywords: Acute lung injury (ALI); Acute respiratory distress syndrome (ARDS); Extracellular vesicles (EVs); Mesenchymal stem cells (MSCs); Pulmonary inflammation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Alveolar cells in normal alveoli and acute lung injury. A variety of alveolar cell types, including epithelial cells, endothelial cells, alveolar macrophages and neutrophils, maintain alveolar functional integrity and homeostasis. The disruption of endothelial-epithelial barrier, the pro-inflammatory polarization of alveolar macrophage, and the formation of neutrophil extracellular traps (NETs) induce acute lung injury
Fig. 2
Fig. 2
Pro-inflammatory EVs can promote the development of ALI/ARDS by regulating alveolar cell phenotype. a EVs induce lung epithelial cell apoptosis and permeability. b EVs weaken the pulmonary vascular endothelial cell junctions and barrier. c EVs promote M1 alveolar macrophage polarization. d EVs induce the formation of neutrophil extracellular traps (NETs) and neutrophil infiltration in lung. All these effects promote the development of ALI/ARDS. EVs extracellular vesicles, ALI/ARDS acute lung injury/acute respiratory distress syndrome
Fig. 3
Fig. 3
Mesenchymal stem cell-derived extracellular vesicles (MSC-EVs) can attenuate ALI/ARDS by suppressing inflammatory responses. a MSC-EVs inhibit epithelial cell apoptosis, restore epithelial cell barrier and improve cell viability. b MSC-EVs promote M2 polarization of alveolar macrophages and inhibit inflammatory reactions. c MSC-EVs maintain endothelial cell permeability and promote cell proliferation. d MSC-EVs inhibit the neutrophil infiltration and neutrophil extracellular traps (NETs) formation. ALI/ARDS acute lung injury/acute respiratory distress syndrome
See this image and copyright information in PMC

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