Fig. 2

Dysregulation of mechanotransduction in ventilator-induced acute lung injury/acute respiratory distress syndrome (ALI/ARDS). In ventilator-induced ALI/ARDS, excessive mechanical forces induce aberrant activation of mechanosensitive ion channels (MSCs)-induced mechanotransduction, which can lead to volutrauma, barotrauma, impaired alveolar fluid clearance, surfactant dysfunction and a pro-inflammatory response and subsequently causes pulmonary edema, aletectrauma and biotrauma. Furthermore, mechanical forces and persistent inflammation also stimulate stimulate cytoskeletal remodeling and extracellular matrix stiffness, which persist during the fibroproliferative phase of ARDS and ultimately lead to pulmonary fibrosis. The fibrotic lung may further enhance MSC-mediated mechanotransduction and exacerbates the progression of ALI/ARDS