Reply: Experimental Acute Lung Injury in Animals: With Age Comes Knowledge

From the Authors:

We thank Schouten et al. for their letter concerning age as an important determinant in all four domains of experimental acute lung injury (ALI). We agree that age has a strong influence in humans on susceptibility to acute respiratory distress syndrome (1), and deserves more attention in the multidimensional approach to experimental ALI. There are also other important factors that affect susceptibility to acute respiratory distress syndrome including co-morbidities such as obesity (2), and risk modifiers such as cigarette smoking (3) and chronic alcohol consumption (4). The goal of our study was to revise and update the 2011 framework for measuring ALI (5), and therefore we did not include a discussion of the role of age, comorbidities, and other modifiers. However, we believe that the ALI framework proposed in our report allows modifiers such as age to be accurately investigated and reported in the context of different experimental ALI models (6). We fully agree with the authors that a close collaboration between pediatric and adult research programs will help better integrate mechanistic and clinical insights across the age spectrum, thereby enhancing bench-to-bedside translation. To that effect, we would encourage the investigation of modifiers of lung injury, specifically age, as a timely topic of a separate workshop.