PDF(Pubmed)
Abstract：
Mechanical ventilation, a lifesaving intervention in critical care, can lead to damage in the extracellular matrix (ECM), triggering inflammation and ventilator-induced lung injury (VILI), particularly in conditions such as acute respiratory distress syndrome (ARDS). This review discusses the detailed structure of the ECM in healthy and ARDS-affected lungs under mechanical ventilation, aiming to bridge the gap between experimental insights and clinical practice by offering a thorough understanding of lung ECM organization and the dynamics of its alteration during mechanical ventilation.
Focusing on the clinical implications, we explore the potential of precise interventions targeting the ECM and cellular signaling pathways to mitigate lung damage, reduce inflammation, and ultimately improve outcomes for critically ill patients. By analyzing a range of experimental studies and clinical papers, particular attention is paid to the roles of matrix metalloproteinases (MMPs), integrins, and other molecules in ECM damage and VILI. This synthesis not only sheds light on the structural changes induced by mechanical stress but also underscores the importance of cellular responses such as inflammation, fibrosis, and excessive activation of MMPs.
This review emphasizes the significance of mechanical cues transduced by integrins and their impact on cellular behavior during ventilation, offering insights into the complex interactions between mechanical ventilation, ECM damage, and cellular signaling. By understanding these mechanisms, healthcare professionals in critical care can anticipate the consequences of mechanical ventilation and use targeted strategies to prevent or minimize ECM damage, ultimately leading to better patient management and outcomes in critical care settings.
Focusing on the clinical implications, we explore the potential of precise interventions targeting the ECM and cellular signaling pathways to mitigate lung damage, reduce inflammation, and ultimately improve outcomes for critically ill patients. By analyzing a range of experimental studies and clinical papers, particular attention is paid to the roles of matrix metalloproteinases (MMPs), integrins, and other molecules in ECM damage and VILI. This synthesis not only sheds light on the structural changes induced by mechanical stress but also underscores the importance of cellular responses such as inflammation, fibrosis, and excessive activation of MMPs.
This review emphasizes the significance of mechanical cues transduced by integrins and their impact on cellular behavior during ventilation, offering insights into the complex interactions between mechanical ventilation, ECM damage, and cellular signaling. By understanding these mechanisms, healthcare professionals in critical care can anticipate the consequences of mechanical ventilation and use targeted strategies to prevent or minimize ECM damage, ultimately leading to better patient management and outcomes in critical care settings.
摘要：
背景：机械通气，危重病护理中的救生干预措施，会导致细胞外基质（ECM）的损伤，引发炎症和呼吸机诱导的肺损伤（VILI），特别是在急性呼吸窘迫综合征（ARDS）等情况下。这篇综述讨论了机械通气下健康和受ARDS影响的肺中ECM的详细结构，旨在通过全面了解肺ECM组织及其在机械通气过程中变化的动力学，弥合实验见解与临床实践之间的差距。
方法：关注临床意义，我们探讨了针对ECM和细胞信号通路的精确干预以减轻肺损伤的潜力，减少炎症，并最终改善危重患者的预后。通过分析一系列实验研究和临床论文，特别注意基质金属蛋白酶(MMPs)的作用，整合素,和其他分子在ECM损伤和VILI。这种合成不仅揭示了机械应力引起的结构变化，而且强调了细胞反应如炎症的重要性。纤维化，以及MMPs的过度激活。
结论：这篇综述强调了整合素转导的机械线索的重要性及其对通气期间细胞行为的影响，提供对机械通风之间复杂相互作用的见解，ECM损坏,和细胞信号。通过了解这些机制，重症监护的医疗保健专业人员可以预测机械通气的后果，并使用有针对性的策略来防止或最小化ECM损害，最终导致在重症监护环境中更好的患者管理和结果。
方法：关注临床意义，我们探讨了针对ECM和细胞信号通路的精确干预以减轻肺损伤的潜力，减少炎症，并最终改善危重患者的预后。通过分析一系列实验研究和临床论文，特别注意基质金属蛋白酶(MMPs)的作用，整合素,和其他分子在ECM损伤和VILI。这种合成不仅揭示了机械应力引起的结构变化，而且强调了细胞反应如炎症的重要性。纤维化，以及MMPs的过度激活。
结论：这篇综述强调了整合素转导的机械线索的重要性及其对通气期间细胞行为的影响，提供对机械通风之间复杂相互作用的见解，ECM损坏,和细胞信号。通过了解这些机制，重症监护的医疗保健专业人员可以预测机械通气的后果，并使用有针对性的策略来防止或最小化ECM损害，最终导致在重症监护环境中更好的患者管理和结果。
