Which of the following cells play a crucial role in the pathogenesis of alveolar-capillary damage in adult respiratory distress syndrome (ARDS)?
Correct Answer: Neutrophils
Description: ARDS, pathologically referred to as diffuse alveolar damage, is a clinical syndrome of acute respiratory failure resulting from diffuse injury to the alveolar/capillary barrier. Such injury may be caused by a great variety of initiating insults, the most frequent of which are shock, severe trauma, sepsis, and gastric aspiration. All these different forms of injury result in recruitment of neutrophils within the alveolar capillaries. Neutrophils release chemokines that attract histiocytes and produce oxygen radicals, prostaglandins, and proteases that damage alveolar epithelium. Formation of hyaline membranes is due to a combination of plasma fluid extravasation and alveolar cell necrosis.CD4+ (helper) lymphocytes, CD8+ (cytotoxic) lymphocytes, eosinophils, and mast cells have been implicated in a number of pulmonary diseases, but not in diffuse alveolar damage. Ref: Chandrasoma P., Taylor C.R. (1998). Chapter 35. The Lung: II. Toxic, Immunologic, & Vascular Diseases. In P. Chandrasoma, C.R. Taylor (Eds), Concise Pathology, 3e.
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