Figure 1.

Rebuilding the injured lung: central themes. The importance of biomechanics and the collaboration between extracellular matrix (ECM) and cell in shaping tissue and organ function received considerable attention, as more crossover scientists (i.e., hybrid physical and biological scientists) bring computational and engineering approaches to understanding form, function, and pathobiology. Fibrosis is hard to stop and reverse because it is driven by a robust network of positive feedback and feed-forward loops that are just beginning to come into focus. The comment about homeostasis being the preferred state emerged in several talks and posters as a strong counter to what many perceived as widespread therapeutic nihilism about arresting or even reversing fibrosis or about promoting lung regeneration. A corollary is that understanding the natural mechanisms involved when injury is effectively repaired and controlled may be one path forward to new therapeutic approaches for acute and chronic lung injury. This includes the immune system and stem and progenitor cells. These natural mechanisms and their response to our interventions are strongly influenced by each individual’s genetic makeup, and we are just beginning to learn how to incorporate OMICs into our clinical trial designs.