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Pulmonary edema, a major manifestation of left ventricular
heart failure,
renal insufficiency,
shock, diffuse alveolar damage and lung
hypersensitivity states, is a significant medical problem worldwide and can be life-threatening. The proinflammatory
cytokine tumor necrosis factor (TNF) has been shown to contribute to the pathogenesis and development of
pulmonary edema. However, some recent studies have demonstrated surprisingly that TNF can also promote alveolar fluid reabsorption in vivo and in vitro. This protective effect of the
cytokine is mediated by the
lectin-like domain of the
cytokine, which is spatially distinct from the
TNF receptor binding sites. The
TIP peptide, a synthetic mimic of the
lectin-like domain of TNF, can significantly increase alveolar fluid clearance and improve lung compliance in
pulmonary edema models. In this review, we will discuss the dual role of TNF in
pulmonary edema.
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