The Role of Neutrophils in ARDS and Drugs that Modify their Formyl Peptide Receptor Activity

Adult Respiratory Distress Syndrome (ARDS) represents a sustained neutrophil driven attack on the lung, where raised alveolar neutrophil numbers are known to predict severity and mortality. Neutrophil infiltration to the lung is in response to released Formyl Peptides from infected and damaged tissue which can drive oxidant and protease release with toxic effects. Formyl Peptides can stimulate neutrophils directly via their surface Formyl Peptide Receptors (FPR’S), escalating their activation and cytokine release. Highly stimulated and stressed neutrophils can be driven to release their nuclear material as Neutrophil Extracellular Traps, producing additional damage and arterial obstruction with increased hypoxaemia and mortality in ARDS.