Bench-to-bedside review: Acute respiratory distress syndrome - How neutrophils migrate into the lung

Jörg Reutershan, Klaus Ley

Research output: Contribution to journalReview articlepeer-review

108 Scopus citations


Acute lung injury and its more severe form, acute respiratory distress syndrome, are major challenges in critically ill patients. Activation of circulating neutrophils and transmigration into the alveolar airspace are associated with development of acute lung injury, and inhibitors of neutrophil recruitment attenuate lung damage in many experimental models. The molecular mechanisms of neutrophil recruitment in the lung differ fundamentally from those in other tissues. Distinct signals appear to regulate neutrophil passage from the intravascular into the interstitial and alveolar compartments. Entry into the alveolar compartment is under the control of CXC chemokine receptor (CXCR)2 and its ligands (CXC chemokine ligand [CXCL]1-8). The mechanisms that govern neutrophil sequestration into the vascular compartment of the lung involve changes in the actin cytoskeleton and adhesion molecules, including selectins, β2 integrins and intercellular adhesion molecule-1. The mechanisms of neutrophil entry into the lung interstitial space are currently unknown. This review summarizes mechanisms of neutrophil trafficking in the inflamed lung and their relevance to lung injury.

Original languageEnglish (US)
Pages (from-to)453-461
Number of pages9
JournalCritical Care
Issue number6
StatePublished - Dec 2004
Externally publishedYes


  • Acute respiratory distress syndrome
  • Adhesion molecules
  • Chemokines
  • Neutrophil recruitment

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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