Ischemia-Reperfusion and Oxidative Stress-Induced Lung Injury

The most significant characteristics of the pulmonary injuries induced by ischemia-reperfusion (IR) include robust inflammatory response, alveolar epithelial cells damage, and increased vascular permeability, which are also the main risk factors for related death, especially in the process of trauma, pulmonary embolism, lung transplantation, and cardiopulmonary bypass. Many factors are involved in this multistep pathophysiologic process directly or indirectly, including reactive oxygen species, immune cells, complement system, proinflammatory cytokines, and other factors. Several preclinical studies have effectively prevented or improved this devastating organ injury, involving the use of various antioxidants, anti-inflammatory agents, mesenchymal stromal cells, and ventilation with gaseous molecules; however, the majority of these have not been translated into clinical use yet. Meanwhile, some randomized controlled trials involving lung IR injury have some limitations. In the future, further studies and ongoing clinical trials are needed to be conducted to reveal the complex mechanism of lung IR injury and develop novel and effective therapeutic approaches.