Drugs to cure avian influenza infection – multiple ways to prevent cell death

Yuan, S

Clinical care of ARDS may result in IR injury of alveolar cells that are poorly ventilated or poorly supplied with blood. Avian-influenza-infected patients often develop the hypoxic pulmonary vasoconstriction (HPV), 24 which is an essential physiological mechanism of the lung that directs blood perfusion from poorly ventilated to well-ventilated lung areas, to optimize gas exchange. But HPV development may cause mismatched blood flow and alveolar ventilation, and may result in life-threatening hypoxemia. 23 Some ARDS clinical cares are usually carried out at this time, for example, mechanical ventilation, high-flow oxygen therapy, corticosteroid treatment and inhaled nitric oxide administration. 23, 24 However, these treatments may restore the blood (and oxygen) supply to the poorly ventilated or poorly supplied alveolar cells, where the damage similar to the IR injury may occur. Upon HPV, mechanical ventilation and high-flow oxygen therapy may restore the oxygen supply to the poorly ventilated alveolar cells. In case of a mismatch of blood flow and alveolar ventilation, corticosteroid treatment and inhaled nitric oxide administration may restore the blood supply to the poorly supplied but well-ventilated alveolar cells. For both the conditions, IR injury or similar damages may occur ( Figure 2 ). In other words, more severe cell death may happen after the ARDS clinical management, but not at the time of occurrences of HPV or hypoxemia. CsA effectively inhibit this kind of damage and therefore may be the key drug for the survival of ARDS patients.