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Ventilation and tumour spread: still a pending matter
PDPI Sulawesi Selatan & Utara, 13 Jan 2023 22:11:12

Liu Zhang, Fang Ying Lu, Shao Guang Huang, Qing Yun Li
European Respiratory Journal 2022 60: 2201674; DOI: 10.1183/13993003.01674-2022


The mechanism of ventilator-induced lung injury (VILI) has attracted considerable attention. López-Alonso et al. [1] reported that mechanical ventilation (MV) influenced lung tumour spread in European Respiratory Journal recently, which provides a novel perspective. For example, during respiratory failure or major surgery without removal of tumour, there might exist a potential risk of metastasis by MV for patients with lung tumours. The study verified that mechanical stretch regulated intracellular cholesterol through PCSK9, which in turn preserved cell stiffness and, subsequently, promoted lung tumour spread. In vivo, the mice were injected with melanoma cells via the jugular vein and were submitted to a 2-h period of MV (peak inspiratory pressure 15 cmH2O, positive end-expiratory pressure (PEEP) 2 cmH2O, 100 breaths per min) or spontaneous breathing, and the results showed that MV increased tumour invasiveness. In vitro, it was demonstrated that stretch increases invasiveness in melanoma B16F10luc2 and lung adenocarcinoma A549 cells. This work explored the effects of MV from a new point of view. However, there are several aspects that we feel need further discussion.

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