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首页> 外文期刊>Inflammation >Inhaled Aerosolized Insulin: A “Topical” Anti-inflammatory Treatment for Acute Lung Injury and Respiratory Distress Syndrome?
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Inhaled Aerosolized Insulin: A “Topical” Anti-inflammatory Treatment for Acute Lung Injury and Respiratory Distress Syndrome?

机译：吸入雾化胰岛素：急性肺损伤和呼吸窘迫综合征的“局部”抗炎治疗？

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Acute lung injury (ALI) and the more severe acute respiratory distress syndrome (ARDS) are forms of pulmonary edema that result from robust local and systemic inflammatory states, such as sepsis. The morbidity and mortality associated with ALI and ARDS are significant and the treatment of these conditions presents a formidable challenge. Controlling hyperglycemia with insulin is a core component of patient management in the critically ill. Insulin treatment also exerts beneficial metabolic effects beyond glucose control, as well as non-metabolic effects, in insulin-resistant states. For instance, insulin inhibits NF-κB—dependent synthesis of pro-inflammatory factors and attenuates production of ROS. Indeed, intravenous administration of insulin ameliorates pulmonary injury and dysfunction in the LPS model of ALI. Most recently, an inhalable insulin formulation was shown to effectively reduce glucose concentrations with minimal impact on long-term pulmonary function. We propose that administering inhalable insulin to hyperglycemic ALI/ARDS patients could directly reduce alveolar inflammation while reducing circulating glucose levels.
机译：急性肺损伤（ALI）和更严重的急性呼吸窘迫综合征（ARDS）是肺水肿的一种形式，其源于强大的局部和全身性炎症状态，例如败血症。与ALI和ARDS相关的发病率和死亡率很高，这些疾病的治疗提出了巨大的挑战。用胰岛素控制高血糖症是重症患者治疗的核心内容。在胰岛素抵抗状态下，胰岛素治疗还具有超出葡萄糖控制范围的有益代谢作用以及非代谢作用。例如，胰岛素抑制NF-κB依赖性的促炎因子合成，并减弱ROS的产生。确实，在LPS模型的ALI中，静脉注射胰岛素可改善肺损伤和功能障碍。最近，显示出可吸入的胰岛素制剂可有效降低葡萄糖浓度，并且对长期肺功能的影响最小。我们建议对高血糖ALI / ARDS患者使用可吸入胰岛素可以直接减轻牙槽炎，同时降低循环葡萄糖水平。

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