ArticleCritical care (London, England)2024
Airway epithelium damage in acute respiratory distress syndrome.
Article in Critical care (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Diffuse alveolar damage, acute respiratory distress syndrome (ARDS), and non-cardiogenic pulmonary edema. Part 1: ARDS endotypes, including systemic inflammatory response syndrome and sepsis, with dog and cat examples.Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc · 2026Review
- pIgR Stem Zone-Targeted Nanobodies as Apical-to-Basolateral Carriers for Inhaled Biologic Delivery Across Mucosal Barriers.Antibodies (Basel, Switzerland) · 2026Article
- Source-controlled bacterial peritonitis improves survival but leaves persistent lung inflammation and airway IgA loss.Intensive care medicine experimental · 2026Article
- Alveolar epithelial barrier disruption by FKBP5-mediated necroptosis aggravates lung injury.Respiratory research · 2026Article
- Regulation of Keratin Chemical Modifications: Potential Molecular Mechanisms in Proliferative Diseases.International journal of molecular sciences · 2026Review
- Tropism, replication competence, and cellular responses of HAdV-14p1 in human airway organoids.iScience · 2026Article
- Bronchoalveolar Lavage Fluid Microbial and Metabolic Alterations Associated with Acute Respiratory Distress Syndrome in Hospitalized Patients with Community-Acquired Pneumonia.Journal of inflammation research · 2026Article
- Crosstalk between the microbiome and the mucosal immunoglobulin A system in the lung, in health and disease.Frontiers in cellular and infection microbiology · 2026Review
- Silent invaders: the role of MPs on epithelium inflammation and damage in airway diseases.Frontiers in allergy · 2026Review
- Immunoglobulin A mucosal immunity in people with cystic fibrosis shortly after initiation of highly effective modulator therapy.ERJ open research · 2025Article
- Anti-SARS-CoV-2 Spike IgA2 Induces Inflammation by Human Macrophages.European journal of immunology · 2025Article
- Review
- Development of an acute lung injury model for drug testing.Scientific reports · 2025Article
- Physiology and pathophysiology of mucus and mucolytic use in critically ill patients.Critical care (London, England) · 2025Review
- Plasma polymeric immunoglobulin receptor exacerbates lung injury inFrontiers in immunology · 2025Article
- Single-Cell Sequencing Redefines Immune Heterogeneity and Communication Networks in ARDS: Toward Precision Therapeutics.International journal of genomics · 2025Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundThe airway epithelium (AE) fulfils multiple functions to maintain pulmonary homeostasis, among which ensuring adequate barrier function, cell differentiation and polarization, and actively transporting immunoglobulin A (IgA), the predominant mucosal immunoglobulin in the airway lumen, via the polymeric immunoglobulin receptor (pIgR). Morphological changes of the airways have been reported in ARDS, while their detailed features, impact for mucosal immunity, and causative mechanisms remain unclear. Therefore, this study aimed to assess epithelial alterations in the distal airways of patients with ARDS.
methodsWe retrospectively analyzed lung tissue samples from ARDS patients and controls to investigate and quantify structural and functional changes in the small airways, using multiplex fluorescence immunostaining and computer-assisted quantification on whole tissue sections. Additionally, we measured markers of mucosal immunity, IgA and pIgR, alongside with other epithelial markers, in the serum and the broncho-alveolar lavage fluid (BALF) prospectively collected from ARDS patients and controls.
resultsCompared to controls, airways of ARDS were characterized by increased epithelial denudation (p = 0.0003) and diffuse epithelial infiltration by neutrophils (p = 0.0005). Quantitative evaluation of multiplex fluorescence immunostaining revealed a loss of ciliated cells (p = 0.0317) a trend towards decreased goblet cells (p = 0.056), and no change regarding cell progenitors (basal and club cells), indicating altered mucociliary differentiation. Increased epithelial permeability was also shown in ARDS with a significant decrease of tight (p < 0.0001) and adherens (p = 0.025) junctional proteins. Additionally, we observed a significant decrease of the expression of pIgR, (p < 0.0001), indicating impaired mucosal IgA immunity. Serum concentrations of secretory component (SC) and S-IgA were increased in ARDS (both p < 0.0001), along other lung-derived proteins (CC16, SP-D, sRAGE). However, their BALF concentrations remained unchanged, suggesting a spillover of airway and alveolar proteins through a damaged AE.
conclusionThe airway epithelium from patients with ARDS exhibits multifaceted alterations leading to altered mucociliary differentiation, compromised defense functions and increased permeability with pneumoproteinemia.
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