关键词：肺;肺癌;干细胞;输血;细胞(生物学);临床医学;扩散;识别;免疫抑制;传染病;军事人员;患者;治疗;毒性;创伤;通风;创伤和损伤
摘 要：Acute lung injury (ALI) is a complex condition associated with diffuse injury to the distal alveolar epithelial gas exchange surface, resulting in marked impairment in the ability to oxygenate blood. Treatment is generally supportive. This condition commonly afflicts patients with cancer. In this regard, cancer patients are especially susceptible to developing acute lung injury (ALI) due to the immunosuppressive and toxic effects of chemotherapy and the debilitating effects of cancer. This condition also afflicts military personnel that experience severe trauma or receive multiple transfusions, and also commonly accompanies severe infections. The over-arching goal of our original application was to derive new approaches to treat ALI with an emphasis on developing new modes of mechanical ventilation and developing cell based strategies to directly repair the injured lung. In Project 1, we proposed to optimize so-called variable ventilation with the intent of minimizing the known injurious effects of conventional mechanical ventilation in patients with ALI. In this past year, where this grant has been in a limited no-cost extension, we have not been using DOD funds for Project 1. Based on data generated from this proposal, however we have been able to secure funds from the Coulter foundation to continue this work by performing a limited clinical study on the safety and efficacy of variable ventilation in patients with ALI. Using the funds that have been available in this no-cost extension has permitted us to continue work on Project 2, which is the cell therapy component. For Project 2, we have continued to develop protocols for the identification and derivation of lung stem cells that can be used for therapeutic purposes in ALI. We also have been identifying other cell populations that can be manipulated to hasten lung repair.