About this Research Topic
The goal of this Research Topic is to integrate and build on the scope of the current Topic entitled 'Understanding Lung Acinar Micromechanics in Health and Disease: Linking Quantitative Imaging and Organ Scale Mechanics by Computational Modeling'. The aim of the present Topic is to evaluate the impact of sequential stages of the oxygen transport chain to assure the efficiency of respiratory function, from the first step, mechanics and gas diffusion, to the final process of cellular energy yield. A debate on the factors limiting the efficiency of the O2 delivery pathway is still open and pivots around the ratio between O2 availability and O2 demand, a point that becomes relevant when performing exercise, particularly in hypoxia. On one hand, one can consider factors increasing the overall efficiency of the pathway, whilst on the other, the limitations imposed by extending observations to conditions ranging from physiology to pathology. Therefore, the scope of the RT includes the identification of potential causes that lead to limitations of the oxygen transport-utilization pathway within healthy subjects, as well as in a wide population of patients, which include cardio-pulmonary disorders and myopathies.
Recent observations suggest the existence of inter-individual differences in the functional adaptive response of the oxygen diffusion-transport phase that are highly relevant in understanding the mechanisms utilized during increased O2 demand. Therefore, one can explore the potential to define individual thresholds of dysregulation signaling a physiologic deviation towards the early stages of a pathological state. This approach may prove useful in understanding the basis for early diagnosis of chronic respiratory disease, as well as providing the ability to follow the recovery phase of acute lung lesions and repair.
Investigation of an integrative approach to the development of knowledge concerning discrete perturbations in the efficiency of the respiratory function are both timely and appropriate. The current RT reflects the growing impact of physiologic systems integration within the vast domain of respiratory medicine.
This Research Topic is open to contributions from integrative and translational research. Contributions may come from multiple sources including experimental physiology, biomedical engineering, numerical models, imaging, molecular biology, as well as focused clinical studies strongly based on a mechanistic approach. Studies may scale over a wide range, from organ to the cellular and molecular level. We sincerely hope that a potential added value of this collection is that of fostering collaborative partnerships and initiatives, to enhance the advancement of knowledge in system integration.
A new and challenging field is represented by the world spreading coronavirus (COVID-19) infection causing interstitial pneumonia. On mechanistic ground, the pathophysiology of this kind of disease has been shown to depend primarily on the disassembly and degradation of the lung interstitial macromolecular organisation causing a remarkable increase in microvascular permeability that results in a strong limitation to gas diffusion. An ongoing discussion is now open as to the best option of medical intervention in relation to the severity of disease, the aim remaining that to guarantee gas diffusion but also allowing conditions favouring the re-deposition of the interstitial matrix, a critical point for full recovery. Such a critical compromise needs to be reached relying either on mechanical ventilation, where inflation pressure ought to be carefully decided, and traditional method of cupping. Frontiers is therefore open to contributions from clinical, pneumological and intensive care units.
We sincerely hope that a potential added value of this collection is that of fostering collaborative partnerships and initiatives, to enhance the advancement of knowledge in system integration.
Keywords: Oxygen demand, Respiratory function, COVID-19, gas exchange, oxygen diffusion-transport
Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.