Matthay Michael A, Folkesson Hans G, Clerici Christine
Cardiovascular Research Institute and Department of Medicine, University of California, San Francisco, California 94143-0624, USA.
Physiol Rev. 2002 Jul;82(3):569-600. doi: 10.1152/physrev.00003.2002.
The discovery of mechanisms that regulate salt and water transport by the alveolar and distal airway epithelium of the lung has generated new insights into the regulation of lung fluid balance under both normal and pathological conditions. There is convincing evidence that active sodium and chloride transporters are expressed in the distal lung epithelium and are responsible for the ability of the lung to remove alveolar fluid at the time of birth as well as in the mature lung when pathological conditions lead to the development of pulmonary edema. Currently, the best described molecular transporters are the epithelial sodium channel, the cystic fibrosis transmembrane conductance regulator, Na+-K+-ATPase, and several aquaporin water channels. Both catecholamine-dependent and -independent mechanisms can upregulate isosmolar fluid transport across the distal lung epithelium. Experimental and clinical studies have made it possible to examine the role of these transporters in the resolution of pulmonary edema.
肺的肺泡和远端气道上皮调节盐和水转运机制的发现，为正常和病理条件下肺液体平衡的调节带来了新的见解。有令人信服的证据表明，活性钠和氯转运体在远端肺上皮中表达，并且在出生时以及病理状况导致肺水肿发生时的成熟肺中，负责肺清除肺泡液体的能力。目前，描述得最为清楚的分子转运体是上皮钠通道、囊性纤维化跨膜电导调节蛋白、钠钾ATP酶以及几种水通道蛋白。儿茶酚胺依赖性和非依赖性机制均可上调远端肺上皮的等渗液体转运。实验和临床研究使得研究这些转运体在肺水肿消退中的作用成为可能。
