Sıçanlarda Akciğer Hasarının Değerlendirilmesi için Kullanılan Histolojik Derecelendirme Sistemleri
Yıl 2024,
, 104 - 112, 30.08.2024
Osman Cengil
,
Mete Keçeci
Öz
Akut solunum sıkıntısı sendromu (ARDS), bakteriyel ve viral pnömoninin yanı sıra birçok nedenin tetiklediği, insanlarda klinik parametrelerin çok iyi tanımlanmış ciddi bir akciğer reaksiyonudur. Ancak deneysel hayvan modelinde ARDS parametrelerine ilişkin kesin bir tanımlama mevcut değildir. Amerikan Toraks Derneği 2010 çalıştay raporuyla laboratuvar hayvanlarında ARDS varlığını belirleyen parankimal dokuda değişiklikler, alveoler-kapiller bariyerin bütünlüğünün değişmesi, iltihaplanma ve anormal akciğer fonksiyonu gibi histopatolojik ana özellikler tanımlamıştır. Bu parametreleri anlamak ve gözlemsel patolojik verileri istatistiksel analiz ve gelişmiş kesinlik için yarı niceliksel veya niceliksel verilere dönüştürmek için doku lezyonlarının skorlanması yöntemi kullanılmaktadır.
Kaynakça
- 1. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory
distress in adults. Lancet. 1967;2(7511):319-23.
- 2. Potere N, Valeriani E, Candeloro M, Tana M, Porreca E, Abbate
A, Spoto S, Rutjes AWS, Di Nisio M. Acute complications
and mortality in hospitalized patients with coronavirus disease
2019: a systematic review and meta-analysis. Critical Care.
2020;24(1):389.
- 3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan
G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin
W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang
R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients
infected with 2019 novel coronavirus in Wuhan, China. Lancet.
2020;395(10223):497-506.
- 4. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, Huang H, Zhang
L, Zhou X, Du C, Zhang Y, Song J, Wang S, Chao Y, Yang Z,
Xu J, Zhou X, Chen D, Xiong W, Xu L, Zhou F, Jiang J, Bai C,
Zheng J, Song Y. Risk Factors Associated With Acute Respiratory
Distress Syndrome and Death in Patients With Coronavirus
Disease 2019 Pneumonia in Wuhan, China. JAMA internal
medicine. 2020;180(7):934-943.
- 5. Engel M, Nowacki RME, Jonker EM, Ophelders D, Nikiforou M,
Kloosterboer N, Zimmermann LJI, van Waardenburg DA, Kramer
BW. A comparison of four different models of acute respiratory
distress syndrome in sheep. Respir Res. 2020;21(1):209.
- 6. Pelosi P, D’Onofrio D, Chiumello D, Paolo S, Chiara G, Capelozzi
VL, Barbas CS, Chiaranda M, Gattinoni L. Pulmonary
and extrapulmonary acute respiratory distress syndrome
are different. The European respiratory journal. Supplement.
2003;42:48s-56s.
- 7. Moreira A, Müller M, Costa PF, Kohl Y. Advanced In Vitro
Lung Models for Drug and Toxicity Screening: The Promising
Role of Induced Pluripotent Stem Cells. Advanced biology.
2022;6(2):e2101139.
- 8. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson
L, Lamy M, Legall JR, Morris A, Spragg R. The American-European
Consensus Conference on ARDS. Definitions, mechanisms,
relevant outcomes, and clinical trial coordination. Am J
Respir Crit Care Med. 1994;149(3 Pt 1):818-24.
- 9. ARDS Definition Task Force; Ranieri VM, Rubenfeld GD,
Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota
L, Slutsky AS. Acute respiratory distress syndrome: the Berlin
Definition. JAMA. 2012;307(23):2526-33.
- 10. Matute-Bello G, Downey G, Moore BB, Groshong SD, Matthay
MA, Slutsky AS, Kuebler WM; Acute Lung Injury in Animals
Study Group. An official American Thoracic Society workshop
report: features and measurements of experimental acute lung
injury in animals. Am J Respir Cell Mol Biol. 2011;44(5):725-38.
- 11. Wang HM, Bodenstein M, Markstaller K. Overview of the pathology
of three widely used animal models of acute lung injury.
European surgical research. 2008;40(4):305-16.
- 12. Matute-Bello G, Frevert CW, Martin TR. Animal models of
acute lung injury. American journal of physiology. Lung cellular
and molecular physiology. 2008;295(3):L379-99.
- 13. Silva IAN, Gvazava N, Bölükbas DA, Stenlo M, Dong J, Hyllen
S, Pierre L, Lindstedt S, Wagner DE. A Semi-quantitative
Scoring System for Green Histopathological Evaluation
of Large Animal Models of Acute Lung Injury. Bio-protocol.
2022;12(16):e4493.
- 14. Klopfleisch R. Multiparametric and semiquantitative scoring
systems for the evaluation of mouse model histopathology--a
systematic review. BMC veterinary research. 2013;9:123.
- 15. Renshaw AA, Gould EW. Measuring errors in surgical pathology
in real-life practice: defining what does and does not matter.
American journal of clinical pathology. 2007;127(1):144-52.
- 16. Kaminsky DA, Cockcroft DW, Davis BE. Respiratory System
Dynamics. Seminars in respiratory and critical care medicine.
2023;44(5):526-537.
- 17. Knudsen L, Ochs M. The micromechanics of lung alveoli: structure
and function of surfactant and tissue components. Histochemistry
and cell biology. 2018;150(6):661-676.
- 18. McLafferty E, Johnstone C, Hendry C, Farley A. Respiratory
system part 1: pulmonary ventilation. Nursing standard.
2013;27(22):40-7.
- 19. Gibson-Corley KN, Olivier AK, Meyerholz DK. Principles for
valid histopathologic scoring in research. Veterinary pathology.
2013;50(6):1007-15.
- 20. Chimenti L, Morales-Quinteros L, Puig F, Camprubi-Rimblas
M, Guillamat-Prats R, Gómez MN, Tijero J, Blanch L, Matute-
Bello G, Artigas A. Comparison of direct and indirect models
of early induced acute lung injury. Intensive Care Med Exp.
2020;8(Suppl 1):62.
- 21. Rosales C. Neutrophil: A Cell with Many Roles in Inflammation
or Several Cell Types? Frontiers in physiology. 2018;9:113.
- 22. Malech HL, Deleo FR, Quinn MT. The role of neutrophils in the
immune system: an overview. Methods in molecular biology.
2014;1124:3-10.
- 23. Ohtsuki Y, Fujita J, Yoshinouchi T, Enzan H, Iguchi M, Lee
GH, Furihata M. Early Stages of Hyaline Membrane Formation
Detected in Alveolar Mouths in Diffuse Alveolar-Damage-Associated
Diseases: A Detailed Immunohistochemical Study. International
journal of surgical pathology. 2015;23(7):524-30.
- 24. Albogami SM, Touman AA. Viral pneumonia and pulmonary alveolar
proteinosis: the cause and the effect, case report. AME
case reports. 2019;3:41.
- 25. Yousem SA. Respiratory bronchiolitis-associated interstitial
lung disease with fibrosis is a lesion distinct from fibrotic nonspecific
interstitial pneumonia: a proposal. Modern pathology.
2006;19(11):1474-9.
- 26. Corrin B, Nicholson AG. Acute alveolar injury and repair. Pathology
of the Lungs. 2011;135–53.
- 27. Li Y, Wang SM, Li X, Lv CJ, Peng LY, Yu XF, Song YJ, Wang
CJ. Pterostilbene pre-treatment reduces LPS-induced acute
lung injury through activating NR4A1. Pharmaceutical biology.
2022;60(1):394-403.
- 28. Zhu L, Wei M, Yang N, Li X. Glycyrrhizic acid alleviates the
meconium-induced acute lung injury in neonatal rats by inhibiting
oxidative stress through mediating the Keap1/Nrf2/HO-1
signal pathway. Bioengineered. 2021;12(1):2616-2626.
- 29. Qin S, Wang H, Liu G, Mei H, Chen M. miR215p ameliorates
hyperoxic acute lung injury and decreases apoptosis of AEC II
cells via PTEN/AKT signaling in rats. Molecular medicine reports.
2019;20(6):4953-4962.
- 30. Li R, Ren T, Zeng J. Mitochondrial Coenzyme Q Protects Sepsis-
Induced Acute Lung Injury by Activating PI3K/Akt/GSK-3β/
mTOR Pathway in Rats. BioMed research international. 2019
Nov;2019:5240898.
- 31. Kim SK, Rho SJ, Kim SH, Kim SY, Song SH, Yoo JY, Kim CH,
Lee SH. Protective effects of diphenyleneiodonium, an NADPH
oxidase inhibitor, on lipopolysaccharide-induced acute lung
injury. Clinical and experimental pharmacology & physiology.
2019;46(2):153-162.
- 32. Cho JY, Kim SJ, Woo CG, Kwon SK, Choe KH, Kim EG, Shin
YM. Altered Lung Heat Shock Protein-70 Expression and Severity
of Sepsis-Induced Acute Lung Injury in a Chronic Kidney
Disease Rat Model. International journal of molecular sciences.
2023;24(6):5641.
- 33. Yan X, Li Y, Choi YH, Wang C, Piao Y, Ye J, Jiang J, Li L, Xu
H, Cui Q, Yan G, Jin M. Protective Effect and Mechanism of
Alprostadil in Acute Respiratory Distress Syndrome Induced
by Oleic Acid in Rats. Medical science monitor. 2018;24:7186-
7198.
- 34. Xiong Z, Xu J, Liu X. Oxymatrine exerts a protective effect in
myocardial ischemia/reperfusioninduced acute lung injury by
inhibiting autophagy in diabetic rats. Mol Molecular medicine
reports. 2021;23(3):183.
- 35. Kong Q, Yuan M, Ming T, Fang Q, Wu X, Song X. Expression
and regulation of tumor necrosis factor-α-induced protein-8-
like 2 is associated with acute lung injury induced by myocardial
ischemia reperfusion in diabetic rats. Microvascular research.
2020;130:104009.
- 36. Chen S, Wu J, Yang L, Tailaiti T, Zou T, Huan Y, Wang J. Dexmedetomidine
Leads to the Mitigation of Myocardial Ischemia/
Reperfusion-Induced Acute Lung Injury in Diabetic Rats Via
Modulation of Hypoxia-Inducible Factor-1α. Brazilian journal of
cardiovascular surgery. 2022;37(3):370-379.
- 37. Ma S, Wang X, Yao J, Cao Q, Zuo X. Roles of apoptosis and
inflammation in a rat model of acute lung injury induced right
ventricular dysfunction. Biomedicine & pharmacotherapy.
2018;108:1105-1114.
- 38. Liu J, Huang X, Hu S, He H, Meng Z. Dexmedetomidine attenuates
lipopolysaccharide induced acute lung injury in rats by
inhibition of caveolin-1 downstream signaling. Biomedicine &
pharmacotherapy. 2019;118:109314.
- 39. Zhang Y, He H, Zhang B, Chen Q, Yao S, Gui P. Amelioration
of Lipopolysaccharide-Induced Acute Lung Injury in Rats
by Na-H Exchanger-1 Inhibitor Amiloride Is Associated with
Reversal of ERK Mitogen-Activated Protein Kinase. BioMed
research international. 2018;2018:3560234.
- 40. Jiang Y, Zhang W. LncRNA ZFAS1 plays a role in regulating
the inflammatory responses in sepsis-induced acute lung injury
via mediating miR-193a-3p. Infection, genetics and evolution.
2021;92:104860.
- 41. Zheng L, Su J, Zhang Z, Jiang L, Wei J, Xu X, Lv S. Salidroside
regulates inflammatory pathway of alveolar macrophages
by influencing the secretion of miRNA-146a exosomes by lung
epithelial cells. Scientific reports. 2020;10(1):20750.
- 42. Fu H, Liang X, Tan W, Hu X. Unraveling the protective mechanisms
of Chuanfangyihao against acute lung injury: Insights
from experimental validation. Experimental and therapeutic
medicine. 2023;26(5):535.
- 43. Zhang FH, Hao H, Liu Y, Fan KL, Dai W, Liu WH, Kong L. Shenmai
Injection Alleviates Acute Lung Injury in a Severe Acute
Pancreatitis Rat Model via Heme Oxygenase-1 Upregulation.
Alternative therapies in health and medicine. 2022;28(2):109-
115.
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kinase 1 (PDK1) inhibits fibrosis and inflammation
in lipopolysaccharide-induced acute lung injury rat model by
attenuating NF-κB/p65 pathway activation. Annals of translational
medicine. 2021;9(22):1671.
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signaling pathway in the protective effects of fasudil against
acute lung injury in septic rats. Molecular medicine reports.
2018;18(5):4486-4498.
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(https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.
jsp)
Histological Scoring Systems for the Assessment of the Degree of Lung Injury in Rats
Yıl 2024,
, 104 - 112, 30.08.2024
Osman Cengil
,
Mete Keçeci
Öz
Acute respiratory distress syndrome (ARDS) is a serious pulmonary reaction with well-defined clinical parameters in humans triggered by many causes besides bacterial and viral pneumonia. However, there is no definitive definition of ARDS parameters in the experimental animal model. With its 2010 workshop report, the American Thoracic Society defined the main histopathological features that determine the presence of ARDS in laboratory animals, such as changes in parenchymal tissue, altered integrity of the alveolar capillary barrier, inflammation, and abnormal lung function. Understanding these parameters, scoring tissue lesions is used to convert observational pathological data into semi-quantitative or quantitative data for statistical analysis and improved precision.
Teşekkür
We would like to thank the Dear Editor and the Referees who contributed to the development of the article.
Kaynakça
- 1. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory
distress in adults. Lancet. 1967;2(7511):319-23.
- 2. Potere N, Valeriani E, Candeloro M, Tana M, Porreca E, Abbate
A, Spoto S, Rutjes AWS, Di Nisio M. Acute complications
and mortality in hospitalized patients with coronavirus disease
2019: a systematic review and meta-analysis. Critical Care.
2020;24(1):389.
- 3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan
G, Xu J, Gu X, Cheng Z, Yu T, Xia J, Wei Y, Wu W, Xie X, Yin
W, Li H, Liu M, Xiao Y, Gao H, Guo L, Xie J, Wang G, Jiang
R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients
infected with 2019 novel coronavirus in Wuhan, China. Lancet.
2020;395(10223):497-506.
- 4. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, Huang H, Zhang
L, Zhou X, Du C, Zhang Y, Song J, Wang S, Chao Y, Yang Z,
Xu J, Zhou X, Chen D, Xiong W, Xu L, Zhou F, Jiang J, Bai C,
Zheng J, Song Y. Risk Factors Associated With Acute Respiratory
Distress Syndrome and Death in Patients With Coronavirus
Disease 2019 Pneumonia in Wuhan, China. JAMA internal
medicine. 2020;180(7):934-943.
- 5. Engel M, Nowacki RME, Jonker EM, Ophelders D, Nikiforou M,
Kloosterboer N, Zimmermann LJI, van Waardenburg DA, Kramer
BW. A comparison of four different models of acute respiratory
distress syndrome in sheep. Respir Res. 2020;21(1):209.
- 6. Pelosi P, D’Onofrio D, Chiumello D, Paolo S, Chiara G, Capelozzi
VL, Barbas CS, Chiaranda M, Gattinoni L. Pulmonary
and extrapulmonary acute respiratory distress syndrome
are different. The European respiratory journal. Supplement.
2003;42:48s-56s.
- 7. Moreira A, Müller M, Costa PF, Kohl Y. Advanced In Vitro
Lung Models for Drug and Toxicity Screening: The Promising
Role of Induced Pluripotent Stem Cells. Advanced biology.
2022;6(2):e2101139.
- 8. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson
L, Lamy M, Legall JR, Morris A, Spragg R. The American-European
Consensus Conference on ARDS. Definitions, mechanisms,
relevant outcomes, and clinical trial coordination. Am J
Respir Crit Care Med. 1994;149(3 Pt 1):818-24.
- 9. ARDS Definition Task Force; Ranieri VM, Rubenfeld GD,
Thompson BT, Ferguson ND, Caldwell E, Fan E, Camporota
L, Slutsky AS. Acute respiratory distress syndrome: the Berlin
Definition. JAMA. 2012;307(23):2526-33.
- 10. Matute-Bello G, Downey G, Moore BB, Groshong SD, Matthay
MA, Slutsky AS, Kuebler WM; Acute Lung Injury in Animals
Study Group. An official American Thoracic Society workshop
report: features and measurements of experimental acute lung
injury in animals. Am J Respir Cell Mol Biol. 2011;44(5):725-38.
- 11. Wang HM, Bodenstein M, Markstaller K. Overview of the pathology
of three widely used animal models of acute lung injury.
European surgical research. 2008;40(4):305-16.
- 12. Matute-Bello G, Frevert CW, Martin TR. Animal models of
acute lung injury. American journal of physiology. Lung cellular
and molecular physiology. 2008;295(3):L379-99.
- 13. Silva IAN, Gvazava N, Bölükbas DA, Stenlo M, Dong J, Hyllen
S, Pierre L, Lindstedt S, Wagner DE. A Semi-quantitative
Scoring System for Green Histopathological Evaluation
of Large Animal Models of Acute Lung Injury. Bio-protocol.
2022;12(16):e4493.
- 14. Klopfleisch R. Multiparametric and semiquantitative scoring
systems for the evaluation of mouse model histopathology--a
systematic review. BMC veterinary research. 2013;9:123.
- 15. Renshaw AA, Gould EW. Measuring errors in surgical pathology
in real-life practice: defining what does and does not matter.
American journal of clinical pathology. 2007;127(1):144-52.
- 16. Kaminsky DA, Cockcroft DW, Davis BE. Respiratory System
Dynamics. Seminars in respiratory and critical care medicine.
2023;44(5):526-537.
- 17. Knudsen L, Ochs M. The micromechanics of lung alveoli: structure
and function of surfactant and tissue components. Histochemistry
and cell biology. 2018;150(6):661-676.
- 18. McLafferty E, Johnstone C, Hendry C, Farley A. Respiratory
system part 1: pulmonary ventilation. Nursing standard.
2013;27(22):40-7.
- 19. Gibson-Corley KN, Olivier AK, Meyerholz DK. Principles for
valid histopathologic scoring in research. Veterinary pathology.
2013;50(6):1007-15.
- 20. Chimenti L, Morales-Quinteros L, Puig F, Camprubi-Rimblas
M, Guillamat-Prats R, Gómez MN, Tijero J, Blanch L, Matute-
Bello G, Artigas A. Comparison of direct and indirect models
of early induced acute lung injury. Intensive Care Med Exp.
2020;8(Suppl 1):62.
- 21. Rosales C. Neutrophil: A Cell with Many Roles in Inflammation
or Several Cell Types? Frontiers in physiology. 2018;9:113.
- 22. Malech HL, Deleo FR, Quinn MT. The role of neutrophils in the
immune system: an overview. Methods in molecular biology.
2014;1124:3-10.
- 23. Ohtsuki Y, Fujita J, Yoshinouchi T, Enzan H, Iguchi M, Lee
GH, Furihata M. Early Stages of Hyaline Membrane Formation
Detected in Alveolar Mouths in Diffuse Alveolar-Damage-Associated
Diseases: A Detailed Immunohistochemical Study. International
journal of surgical pathology. 2015;23(7):524-30.
- 24. Albogami SM, Touman AA. Viral pneumonia and pulmonary alveolar
proteinosis: the cause and the effect, case report. AME
case reports. 2019;3:41.
- 25. Yousem SA. Respiratory bronchiolitis-associated interstitial
lung disease with fibrosis is a lesion distinct from fibrotic nonspecific
interstitial pneumonia: a proposal. Modern pathology.
2006;19(11):1474-9.
- 26. Corrin B, Nicholson AG. Acute alveolar injury and repair. Pathology
of the Lungs. 2011;135–53.
- 27. Li Y, Wang SM, Li X, Lv CJ, Peng LY, Yu XF, Song YJ, Wang
CJ. Pterostilbene pre-treatment reduces LPS-induced acute
lung injury through activating NR4A1. Pharmaceutical biology.
2022;60(1):394-403.
- 28. Zhu L, Wei M, Yang N, Li X. Glycyrrhizic acid alleviates the
meconium-induced acute lung injury in neonatal rats by inhibiting
oxidative stress through mediating the Keap1/Nrf2/HO-1
signal pathway. Bioengineered. 2021;12(1):2616-2626.
- 29. Qin S, Wang H, Liu G, Mei H, Chen M. miR215p ameliorates
hyperoxic acute lung injury and decreases apoptosis of AEC II
cells via PTEN/AKT signaling in rats. Molecular medicine reports.
2019;20(6):4953-4962.
- 30. Li R, Ren T, Zeng J. Mitochondrial Coenzyme Q Protects Sepsis-
Induced Acute Lung Injury by Activating PI3K/Akt/GSK-3β/
mTOR Pathway in Rats. BioMed research international. 2019
Nov;2019:5240898.
- 31. Kim SK, Rho SJ, Kim SH, Kim SY, Song SH, Yoo JY, Kim CH,
Lee SH. Protective effects of diphenyleneiodonium, an NADPH
oxidase inhibitor, on lipopolysaccharide-induced acute lung
injury. Clinical and experimental pharmacology & physiology.
2019;46(2):153-162.
- 32. Cho JY, Kim SJ, Woo CG, Kwon SK, Choe KH, Kim EG, Shin
YM. Altered Lung Heat Shock Protein-70 Expression and Severity
of Sepsis-Induced Acute Lung Injury in a Chronic Kidney
Disease Rat Model. International journal of molecular sciences.
2023;24(6):5641.
- 33. Yan X, Li Y, Choi YH, Wang C, Piao Y, Ye J, Jiang J, Li L, Xu
H, Cui Q, Yan G, Jin M. Protective Effect and Mechanism of
Alprostadil in Acute Respiratory Distress Syndrome Induced
by Oleic Acid in Rats. Medical science monitor. 2018;24:7186-
7198.
- 34. Xiong Z, Xu J, Liu X. Oxymatrine exerts a protective effect in
myocardial ischemia/reperfusioninduced acute lung injury by
inhibiting autophagy in diabetic rats. Mol Molecular medicine
reports. 2021;23(3):183.
- 35. Kong Q, Yuan M, Ming T, Fang Q, Wu X, Song X. Expression
and regulation of tumor necrosis factor-α-induced protein-8-
like 2 is associated with acute lung injury induced by myocardial
ischemia reperfusion in diabetic rats. Microvascular research.
2020;130:104009.
- 36. Chen S, Wu J, Yang L, Tailaiti T, Zou T, Huan Y, Wang J. Dexmedetomidine
Leads to the Mitigation of Myocardial Ischemia/
Reperfusion-Induced Acute Lung Injury in Diabetic Rats Via
Modulation of Hypoxia-Inducible Factor-1α. Brazilian journal of
cardiovascular surgery. 2022;37(3):370-379.
- 37. Ma S, Wang X, Yao J, Cao Q, Zuo X. Roles of apoptosis and
inflammation in a rat model of acute lung injury induced right
ventricular dysfunction. Biomedicine & pharmacotherapy.
2018;108:1105-1114.
- 38. Liu J, Huang X, Hu S, He H, Meng Z. Dexmedetomidine attenuates
lipopolysaccharide induced acute lung injury in rats by
inhibition of caveolin-1 downstream signaling. Biomedicine &
pharmacotherapy. 2019;118:109314.
- 39. Zhang Y, He H, Zhang B, Chen Q, Yao S, Gui P. Amelioration
of Lipopolysaccharide-Induced Acute Lung Injury in Rats
by Na-H Exchanger-1 Inhibitor Amiloride Is Associated with
Reversal of ERK Mitogen-Activated Protein Kinase. BioMed
research international. 2018;2018:3560234.
- 40. Jiang Y, Zhang W. LncRNA ZFAS1 plays a role in regulating
the inflammatory responses in sepsis-induced acute lung injury
via mediating miR-193a-3p. Infection, genetics and evolution.
2021;92:104860.
- 41. Zheng L, Su J, Zhang Z, Jiang L, Wei J, Xu X, Lv S. Salidroside
regulates inflammatory pathway of alveolar macrophages
by influencing the secretion of miRNA-146a exosomes by lung
epithelial cells. Scientific reports. 2020;10(1):20750.
- 42. Fu H, Liang X, Tan W, Hu X. Unraveling the protective mechanisms
of Chuanfangyihao against acute lung injury: Insights
from experimental validation. Experimental and therapeutic
medicine. 2023;26(5):535.
- 43. Zhang FH, Hao H, Liu Y, Fan KL, Dai W, Liu WH, Kong L. Shenmai
Injection Alleviates Acute Lung Injury in a Severe Acute
Pancreatitis Rat Model via Heme Oxygenase-1 Upregulation.
Alternative therapies in health and medicine. 2022;28(2):109-
115.
- 44. Yang K, Li B, Chen J. Knockdown of phosphoinositide-dependent
kinase 1 (PDK1) inhibits fibrosis and inflammation
in lipopolysaccharide-induced acute lung injury rat model by
attenuating NF-κB/p65 pathway activation. Annals of translational
medicine. 2021;9(22):1671.
- 45. Wang Y, Wang X, Liu W, Zhang L. Role of the Rho/ROCK
signaling pathway in the protective effects of fasudil against
acute lung injury in septic rats. Molecular medicine reports.
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