Faculdade de Medicina da Universidade de São Paulo, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil.
J Bras Pneumol. 2010 May-Jun;36(3):363-71. doi: 10.1590/s1806-37132010000300015.
Although mechanical ventilation is an important therapy, it can result in complications. One major complication is ventilator-induced lung injury, which is caused by alveolar hyperdistension, leading to an inflammatory process, with neutrophilic infiltration, hyaline membrane formation, fibrogenesis and impaired gas exchange. In this process, cellular mechanotransduction of the overstretching stimulus is mediated by means of the cytoskeleton and its cell-cell and cell-extracellular matrix interactions, in such a way that the mechanical stimulus of ventilation is translated into an intracellular biochemical signal, inducing endothelial activation, pulmonary vascular permeability, leukocyte chemotaxis, cytokine production and, possibly, distal organ failure. Clinical studies have shown the relationship between pulmonary distension and mortality in patients with ventilator-induced lung injury. However, although the cytoskeleton plays a fundamental role in the pathogenesis of ventilator-induced lung injury, there have been few in vivo studies of alterations in the cytoskeleton and in cytoskeleton-associated proteins during this pathological process.
尽管机械通气是一种重要的治疗方法，但它可能会导致并发症。其中一个主要的并发症是呼吸机相关性肺损伤，这是由肺泡过度膨胀引起的，导致炎症过程，伴有中性粒细胞浸润、透明膜形成、纤维化和气体交换受损。在这个过程中，细胞外基质和细胞-细胞外基质相互作用的细胞骨架介导了细胞的机械转导刺激，从而使通气的机械刺激转化为细胞内的生化信号，诱导内皮细胞激活、肺血管通透性增加、白细胞趋化、细胞因子产生，并且可能导致远端器官衰竭。临床研究表明，呼吸机相关性肺损伤患者的肺扩张与死亡率之间存在关系。然而，尽管细胞骨架在呼吸机相关性肺损伤的发病机制中起着至关重要的作用，但在这一病理过程中，细胞骨架和细胞骨架相关蛋白的改变很少有体内研究。
