Acute lung injury

Potential Effects of Medicinal Plants and Secondary Metabolites on Acute Lung Injury

“…ALI is a life-threatening syndrome that causes high morbidity and mortality [8–12]; however, the worldwide incidence is variable, reaching, for example, 64.2 to 78.9 cases/100,000 person-years in the United States and 17 cases/100,000 person-years in Northern Europe, with an estimated 74,500 deaths annually [13]. Patients admitted to intensive care units are most affected by ALI (1 in 10) [14]. However, individuals with multiple comorbidities, chronic alcohol abuse, or chronic lung disease also present a high risk of developing ALI [15, 16].…”

“…However, individuals with multiple comorbidities, chronic alcohol abuse, or chronic lung disease also present a high risk of developing ALI [15, 16]. The causes of ALI may be direct, such as pneumonia , inhalation injury, aspiration of gastric contents, inhalation injury, chest trauma, and near drowning, or indirect, such as sepsis, burns, pancreatitis, fat embolism, hypovolemia, and blood transfusion [8, 14]. The pathogenesis of ALI involves increased permeability of the alveolar-capillary membrane, accumulation of protein-rich fluid in the airspaces, pulmonary edema, and pulmonary infiltration of neutrophils, mainly bilateral, resulting in poor lung compliance, diffuse alveolar damage, and, consequently, acute hypoxemic respiratory failure [8, 17–23].…”

“…The inflammatory process of ALI can be classified into three stages: exudative, proliferative, and fibrotic stages [4, 9, 14]. The exudative stage is characterized by intense neutrophilic infiltrate, edema, and protein-rich fluid due to pulmonary capillary leakage [14].…”

“…The exudative stage is characterized by intense neutrophilic infiltrate, edema, and protein-rich fluid due to pulmonary capillary leakage [14]. The proliferative stage ensues as a consequence, the development of which is marked by proliferation and phenotypic changes in type II alveolar cells and fibroblasts [20].…”

“…In the absence of recovery, the fibrotic stage develops, which is characterized by diffuse fibrosis and modulation of the structural architecture remodeling of the lung. These stages characterize the chronic phase of ALI, leading to the formation of fibrotic scarring in the lung [9, 14]. …”