The lung must maintain a proper barrier between airspaces and fluid
filled tissues in order to maintain lung fluid balance. Central to maintaining
lung fluid balance are epithelial cells which create a barrier to water and
solutes. The barrier function of these cells is mainly provided by tight
junction proteins known as claudins. Epithelial barrier function varies
depending on the different needs within the segments of the respiratory tree. In
the lower airways, fluid is required to maintain mucociliary clearance, whereas
in the terminal alveolar airspaces a thin layer of surfactant enriched fluid
lowers surface tension to prevent airspace collapse and is critical for gas
exchange. As the epithelial cells within the segments of the respiratory tree
differ, the composition of claudins found in these epithelial cells is also
different. Among these differences is claudin-18 which is uniquely expressed by
the alveolar epithelial cells. Other claudins, notably claudin-4 and claudin-7,
are more ubiquitously expressed throughout the respiratory epithelium. Claudin-5
is expressed by both pulmonary epithelial and endothelial cells. Based on
in vitro and in vivo model systems and
histologic analysis of lungs from human patients, roles for specific claudins in
maintaining barrier function and protecting the lung from the effects of acute
injury and disease are being identified. One surprising finding is that
claudin-18 and claudin-4 control lung cell phenotype and inflammation beyond
simply maintaining a selective paracellular permeability barrier. This suggests
claudins have more nuanced roles for the control of airway and alveolar
physiology in the healthy and diseased lung.