Conceptual approaches to lung injury and repair

Lung injury and repair is a broad topic that includes many cell types and is relevant to the pathogenesis of most lung diseases. Here, we focus on injury and repair of the alveolus, the principal function of which is to achieve gas exchange. The many cell types and structures present in the alveolus are discussed, with emphasis on their interactions in both health and disease. We define injury as damage resulting in impaired gas exchange; physiologic repair, then, requires restoration of normal alveolar architecture and function. The role of inflammation in both injury and repair of structural alveolar cells, particularly epithelial cells, as well as mechanisms of resolution of inflammation will be addressed. Finally, emphasis is placed on the importance of addressing quantitatively the dynamic and complex multidirectional interactions between the many alveolar cell types and structures in three dimensions over time and in relating such mechanistic studies to physiologic outcomes and human disease.