Translational medicine for acute lung injury

Abstract

Acute lung injury (ALI) is a complex disease with numerous causes. This review begins with a discussion of disease development from direct or indirect pulmonary insults, as well as varied pathogenesis. The heterogeneous nature of ALI is then elaborated upon, including its epidemiology, clinical manifestations, potential biomarkers, and genetic contributions. Although no medication is currently approved for this devastating illness, supportive care and pharmacological intervention for ALI treatment are summarized, followed by an assessment of the pathophysiological gap between human ALI and animal models. Lastly, current research progress on advanced nanomedicines for ALI therapeutics in preclinical and clinical settings is reviewed, demonstrating new opportunities towards developing an effective treatment for ALI.

Keywords: Acute lung injury; Acute respiratory distress syndrome; Animal model; Drug delivery; Nanomedicine; Therapy.

Fig. 1

Graphics indicating the normal alveolus and ALI/ARDS alveolus. The right alveolus is a schematic representation of the main pathophysiological features of ALI/ARDS. Each therapeutic agent acts through a specific mechanism as indicated and these machineries in detail were reviewed elsewhere [181, 182]. PECAM-1 = platelet-endothelial cell adhesion molecule-1, VEGF = vascular endothelial growth factor, PAF-AH = platelet-activating factor acetyl hydrolase

Fig. 2

Major differences in anatomical features of the human and mouse lungs. More comparisons of microscopic airway anatomy and biochemical characteristics between humans and mice were reviewed elsewhere [43, 154]

Fig. 3

Nanomedicine for ALI/ARDS. Various nanomaterials can be fabricated, including biogenic extracellular vesicles and synthetic lipid (liposome) and polymer nanoparticles, to intervene in the pathophysiological processes of ALI/ARDS for enhanced treatment