Document Detail

Role of endothelin-1 in acute lung injury.
MedLine Citation:
PMID:  19446279     Owner:  NLM     Status:  MEDLINE    
The alveolar-capillary membrane serves as a barrier that prevents the accumulation of fluid in the alveolar space and restricts the diffusion of large solutes while facilitating an efficient gas exchange. When this barrier becomes dysfunctional, patients develop acute lung injury (ALI), which is characterized by pulmonary edema and increased lung inflammation that leads to a life-threatening impairment of gas exchange. In addition to the increase of inflammatory cytokines, plasma levels of endothelin-1 (ET-1), which is a primarily endothelium-derived vasoconstrictor, are increased in patients with ALI. As patients recover, ET-1 levels decrease, which suggests that ET-1 may not only be a marker of endothelial dysfunction but may have a role in the pathogenesis of ALI. While pulmonary edema accumulates, alveolar fluid clearance (AFC) is of critical importance, as failure to return to normal clearance is associated with poor prognosis in patients with pulmonary edema. AFC involves active transport mechanisms where sodium (Na(+)) is actively transported from the alveolar airspaces, across the alveolar epithelium, and into the pulmonary circulation, which creates an osmotic gradient that is responsible for the clearance of lung edema. In this article, we review the relevance of ET-1 in the development of ALI, not only as a vasoconstrictor molecule but also by inhibiting AFC via the activation of endothelial ET-B receptors and generation. Furthermore, this review highlights the therapeutic role of drugs such as beta-adrenergic agonists and, in particular, of endothelin receptor antagonists in patients with ALI.
Alejandro P Comellas; Arturo Briva
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Review     Date:  2009-03-20
Journal Detail:
Title:  Translational research : the journal of laboratory and clinical medicine     Volume:  153     ISSN:  1931-5244     ISO Abbreviation:  Transl Res     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-18     Completed Date:  2009-07-10     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101280339     Medline TA:  Transl Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  263-71     Citation Subset:  AIM; IM    
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MeSH Terms
Acute Lung Injury / drug therapy,  physiopathology*
Adrenergic beta-Agonists / therapeutic use
Endothelin-1 / physiology*
Receptors, Endothelin / antagonists & inhibitors
Grant Support
K01 HL080966/HL/NHLBI NIH HHS; K01 HL080966-01A1/HL/NHLBI NIH HHS; K01HL080966-01/HL/NHLBI NIH HHS
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Endothelin-1; 0/Receptors, Endothelin

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