A Conserved Distal Lung Regenerative Pathway in Acute Lung Injury.

Journal Article (Journal Article)

Improved tools have led to a burgeoning understanding of lung regeneration in mice, but it is not yet known how these insights may be relevant to acute lung injury in humans. We report in detail two cases of fulminant idiopathic acute lung injury requiring extracorporeal membrane oxygenation in previously healthy young adults with acute respiratory distress syndrome, one of whom required lung transplantation. Biopsy specimens showed diffuse alveolar injury with a striking paucity of alveolar epithelial regeneration, rare hyaline membranes, and diffuse contiguous airspace lining by macrophages. This novel constellation was termed diffuse alveolar injury with delayed epithelization. In addition, mirroring data from murine models of lung injury/regeneration, peribronchiolar basaloid pods (previously described as squamous metaplasia) and ciliated bronchiolarization were identified in these patients and in 39% of 57 historical cases with diffuse alveolar damage. These findings demonstrate a common and clinically relevant human disease correlate for murine models of severe acute lung injury. Evidence suggests that peribronchiolar basaloid pods and bronchiolarization are related spatially and temporally and likely represent overlapping sequential stages of the response to severe distal airway injury.

Full Text

Duke Authors

Cited Authors

  • Taylor, MS; Chivukula, RR; Myers, LC; Jeck, WR; Waghray, A; Tata, PR; Selig, MK; O'Donnell, WJ; Farver, CF; Thompson, BT; Rajagopal, J; Kradin, RL

Published Date

  • May 2018

Published In

Volume / Issue

  • 188 / 5

Start / End Page

  • 1149 - 1160

PubMed ID

  • 29476724

Pubmed Central ID

  • PMC5906746

Electronic International Standard Serial Number (EISSN)

  • 1525-2191

Digital Object Identifier (DOI)

  • 10.1016/j.ajpath.2018.01.021


  • eng

Conference Location

  • United States