Acute Lung Injury

The mission of the acute lung injury pillar of the Critical Illness and Injury Research Centre is to foster and deliver internationally leading research into the causes, consequences and therapy of acute respiratory distress syndrome (ARDS).

Acute Lung Injury - Wolfgang Kuebler

St Michael’s Hospital is already a world leader in ALI/ARDS basic science and clinical research. Our investigators study different aspects of ALI, from epidemiology to predictive and prognostic biomarkers and genetic polymorphisms to treatment interventions.

One major research interest relates to the lung injury caused by mechanical ventilation, the supportive therapy necessary to sustain life in patients with severe respiratory failure. Termed ventilator-induced lung injury (VILI), our focus is on understanding the mechanisms by which injurious forms of mechanical ventilation can lead to multiple organ dysfunction syndrome, and in developing more physiologic approaches to mechanical ventilation, as well as developing non-ventilatory approaches that can mitigate the severity of VILI.

ALI/ARDS is also a major focus of the Toronto ARDS Critical Illness Cell Therapy (TACCT) group, established and directed by Drs. John Laffey and Arthur Slutsky. This group is a network of respiratory and cardiovascular research programs (clinician and basic scientists) in Toronto with an interest in cell therapies for ALI/ARDS and brings together experts in cell biology and genomics, pre-clinical ARDS research and translation to clinical trials.

The research environment is intended to foster productive interactions between basic and clinical scientists. Members of the research group include fellows and faculty from the departments of Medicine, Anesthesia, Surgery and Emergency Medicine. We aim to nurture and develop the most promising young scientists to become the next generation of world-class lung injury researchers. We expect that this collaboration will promote translational and clinical research that will lead to reduced mortality from ALI and a better quality of life for survivors.

Explore our research

Our group of acute lung injury (ALI) investigators has multiple active research programs that are taking novel approaches to the prevention, early diagnosis and treatment of ALI.

Featured research includes:

  • Laboratory-based molecular, cell and preclinical models of acute lung injury, with a focus on understanding the pathogenesis and resolution of inflammation, infections and alveolar-capillary permeability during ALI
  • Endothelial cell dysfunction during critical illness, regulation of transcellular and paracellular permeability, for example during influenza infection
  • Biologic and therapeutic effects of allogeneic human mesenchymal stem cells (MSCs) using molecular techniques and preclinical models to optimize cell therapy approaches.
  • Basic and translational research on how platelets can contribute to ALI and the use of platelet inhibitors as treatment for ALI
  • State-of-the-art imaging of ALI with the use of intravital microscopy and real-time fluorescence imaging techniques in intact organs injury models
  • Exploiting whole genome approaches, such as microarray technology, to identify novel molecular targets for ALI which can be used to predict who develops ALI and how these markers can predict the clinical outcome of ALI
  • Clinical research focusing on biologic and clinical predictors for developing acute lung injury, as well as the pathogenesis and resolution of lung injury
  • Highly innovative research on new modes and new approaches to mechanical ventilation, tested both in animal models and in clinical physiological studies
  • Clinical and translational research on how critically ill patients interact with the ventilator (respiratory mechanics, respiratory muscle activity, sleep, etc.) and on how this affects patient outcomes
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