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我们对晚期肺发育和支气管肺发育不良机制的理解的最新进展。

Recent advances in our understanding of the mechanisms of late lung development and bronchopulmonary dysplasia.

作者信息

Surate Solaligue David E, Rodríguez-Castillo José Alberto, Ahlbrecht Katrin, Morty Rory E

机构信息

Department of Lung Development and Remodelling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany; and.

Department of Internal Medicine (Pulmonology), University of Giessen and Marburg Lung Center, German Center for Lung Research, Giessen, Germany.

出版信息

Am J Physiol Lung Cell Mol Physiol. 2017 Dec 1;313(6):L1101-L1153. doi: 10.1152/ajplung.00343.2017. Epub 2017 Sep 28.

Abstract

The objective of lung development is to generate an organ of gas exchange that provides both a thin gas diffusion barrier and a large gas diffusion surface area, which concomitantly generates a steep gas diffusion concentration gradient. As such, the lung is perfectly structured to undertake the function of gas exchange: a large number of small alveoli provide extensive surface area within the limited volume of the lung, and a delicate alveolo-capillary barrier brings circulating blood into close proximity to the inspired air. Efficient movement of inspired air and circulating blood through the conducting airways and conducting vessels, respectively, generates steep oxygen and carbon dioxide concentration gradients across the alveolo-capillary barrier, providing ideal conditions for effective diffusion of both gases during breathing. The development of the gas exchange apparatus of the lung occurs during the second phase of lung development-namely, late lung development-which includes the canalicular, saccular, and alveolar stages of lung development. It is during these stages of lung development that preterm-born infants are delivered, when the lung is not yet competent for effective gas exchange. These infants may develop bronchopulmonary dysplasia (BPD), a syndrome complicated by disturbances to the development of the alveoli and the pulmonary vasculature. It is the objective of this review to update the reader about recent developments that further our understanding of the mechanisms of lung alveolarization and vascularization and the pathogenesis of BPD and other neonatal lung diseases that feature lung hypoplasia.

摘要

肺发育的目标是生成一个气体交换器官,该器官既要提供薄的气体扩散屏障,又要提供大的气体扩散表面积,同时还要产生陡峭的气体扩散浓度梯度。因此,肺的结构非常完美,能够承担气体交换的功能:大量小肺泡在有限的肺容积内提供了广泛的表面积,而脆弱的肺泡-毛细血管屏障使循环血液与吸入的空气紧密相邻。吸入的空气和循环血液分别通过传导气道和传导血管的高效流动,在肺泡-毛细血管屏障上产生陡峭的氧气和二氧化碳浓度梯度,为呼吸过程中两种气体的有效扩散提供了理想条件。肺气体交换装置的发育发生在肺发育的第二阶段,即肺发育后期,包括肺发育的小管期、囊泡期和肺泡期。正是在这些肺发育阶段,早产婴儿出生,此时肺还不能进行有效的气体交换。这些婴儿可能会患上支气管肺发育不良(BPD),这是一种因肺泡和肺血管发育紊乱而复杂化的综合征。本综述的目的是向读者介绍最新进展,这些进展能加深我们对肺泡化和血管化机制以及BPD和其他以肺发育不全为特征的新生儿肺部疾病发病机制的理解。

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