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Pathogenesis of the ARDS is triggered after an initial injury that interacts through alarmin receptors and toll like receptors activating nuclear transcription factors including NF-Kappa-beta. Then a powerful acute immune response triggered mainly by IL-1B causes macrophage/neutrophil activation and recruitment. The cell mediated immune response produces tissue damage mediated by NOS and NETs allowing the development of edema and epithelial damage.
