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CORTISOL secretion by the cortex of e adrenal glands (Fig. 32.1) increases in response to any stress in the body, whether physical (such as illness, trauma, surgery or temperature extremes) or psychological. However, this hormone is more than a simple marker of stress levels—it is necessary for the correct functioning of almost every part of the body. Excesses or deficiencies of this crucial hormone also lead to various physical symptoms and disease states [1]. Although cortisol is not essential for life per se, it helps an organism to cope more efficiently with its environment with particular metabolic actions on glucose production and protein and fat catabolism. Nevertheless, loss or profound diminishment of cortisol secretion leads to a state of abnormal metabolism and an inability to deal with stressors, which, if untreated, may be fatal [1, 2].

Supplemental material, sj-pdf-4-pul-10.1177_2045894021996190 for Extracellular matrix degradation pathways and fatty acid metabolism regulate distinct pulmonary vascular cell types in pulmonary arterial hypertension by Sharon Mumby, F. Perros, C. Hui, B.L. Xu, W. Xu, V Elyasigomari, A. Hautefort, G. Manaud, M. Humbert, K.F. Chung, S.J. Wort and I.M. Adcock in Pulmonary Circulation

Supplemental material, sj-pdf-3-pul-10.1177_2045894021996190 for Extracellular matrix degradation pathways and fatty acid metabolism regulate distinct pulmonary vascular cell types in pulmonary arterial hypertension by Sharon Mumby, F. Perros, C. Hui, B.L. Xu, W. Xu, V Elyasigomari, A. Hautefort, G. Manaud, M. Humbert, K.F. Chung, S.J. Wort and I.M. Adcock in Pulmonary Circulation

Supplemental material, sj-pdf-2-pul-10.1177_2045894021996190 for Extracellular matrix degradation pathways and fatty acid metabolism regulate distinct pulmonary vascular cell types in pulmonary arterial hypertension by Sharon Mumby, F. Perros, C. Hui, B.L. Xu, W. Xu, V Elyasigomari, A. Hautefort, G. Manaud, M. Humbert, K.F. Chung, S.J. Wort and I.M. Adcock in Pulmonary Circulation

Supplemental material, sj-pdf-1-pul-10.1177_2045894021996190 for Extracellular matrix degradation pathways and fatty acid metabolism regulate distinct pulmonary vascular cell types in pulmonary arterial hypertension by Sharon Mumby, F. Perros, C. Hui, B.L. Xu, W. Xu, V Elyasigomari, A. Hautefort, G. Manaud, M. Humbert, K.F. Chung, S.J. Wort and I.M. Adcock in Pulmonary Circulation

According to the World Health Organization (WHO), trauma is responsible for 10% of deaths and 16% of disabilities worldwide. This is considerably higher than those for malaria, tuberculosis, and HIV/AIDS combined. While the human suffering and death caused by injury is well-recognized, injury has a significant medical care cost. Better prediction of the state of trauma patients in the days immediately after trauma may reduce costs. Traumatic injuries to multiple organs can cause dysfunction in all systems of the body especially the immune system placing patients at high risk of infections and inflammatory complications which are often fatal. Neutrophils are the most abundant leukocyte in the human circulation and are crucial for the prevention of microbial disease. Significant changes in neutrophil functions such as enhanced chemotaxis, Neutrophil extracellular trap (NET)-induced cell death (NETosis), and phagocytosis occur early after injury followed by prolonged functional defects such as phagocytosis, killing mechanisms, and receptor expression. Analysis of these changes may improve the prediction of the patient's condition over time. We provide a comprehensive and up-to-date review of the literature investigating the effect of trauma on neutrophil phenotype with an underlying goal of using this knowledge to examine the predictive potential of neutrophil alterations on secondary complications in patients with traumatic injuries. We conclude that alterations in neutrophil surface markers and functions may be potential biomarkers that predict the outcome of trauma patients.

Exosomes are nanosized vesicles and have recently been recognized as important players in cell-to-cell communication. Exosomes contain different mediators such as proteins, nucleic acids (DNA, mRNA, miRNAs, and other ncRNAs), and lipid mediators and can shuttle their exosomal content to both neighboring and distal cells. Exosomes are very effective in orchestrating immune responses in the airways and all cell types can contribute to the systemic exosome pool. Intracellular communication between the broad range of cell types within the lung is crucial in disease emphasizing the importance of exosomes. In asthma, exosomes affect the inflammatory microenvironment which ultimately determines the development or alleviation of the pathological symptoms. Recent studies in this area have provided insight into the underlying mechanisms of disease and led to interest in using exosomes as potential novel therapeutic agents.

The multifunctional role of mast cells (MCs) in the immune system is complex and has not fully been explored. MCs reside in tissues and mucous membranes such as the lung, digestive tract, and skin which are strategically located at interfaces with the external environment. These cells, therefore, will encounter external stimuli and pathogens. MCs modulate both the innate and the adaptive immune response in inflammatory disorders including transplantation. MCs can have pro- and anti-inflammatory functions, thereby regulating the outcome of lung transplantation through secretion of mediators that allow interaction with other cell types, particularly innate lymphoid cells (ILC2). ILC2 cells are a unique population of hematopoietic cells that coordinate the innate immune response against a variety of threats including infection, tissue damage, and homeostatic disruption. In addition, MCs can modulate alloreactive T cell responses or assist in T regulatory (Treg) cell activity. This paper outlines the current understanding of the role of MCs in lung transplantation, with a specific focus on their interaction with ILC2 cells within the engrafted organ.