Over the last couple of decades, our understanding of lung injury and the support of the injured lung has evolved significantly.
The lungs are an expansive organ with relatively fewer cells than other organs but have great ability to heal and regenerate the injured epithelial, endothelial and supporting matrix.
However, the healing process could be different in different pathologies, different acuities, different ages.
The ultimate repair of the injured lungs is through regeneration (making new cells), however through many different inflammatory and immune pathways sometimes repair (scarring/fibrosis) occurs, and in chronic lung conditions, modulation or dysregulated repair can occur leading to further worsening of lung function.
Our research focus has been mainly on supporting the injured lung till healing or improvement occurs, treating the inflammatory/infectious pathologies, and concurrently trying to minimize further lung injury.
Unfortunately, much less focus, research and investments has been allocated to the healing process. The healing process can take up to weeks or months and studies have shown that patients who survive from ARDS can still be symptomatic 6-12 months after.
Currently, our only long-term hope especially for the chronically injured failling lung is lung transplant.
Stem cell research is still considered in its infancy but there is some slow progress in identifying progenitor cells that hopefully can be used as a target for new therapies.
I hope we focus and invest in this extremely important process that might improve outcomes and lives.
From: Lucas, A., Yasa, J. and Lucas, M. (2020), Regeneration and repair in the healing lung. Clin Transl Immunol, 9: e1152.
