<p><b>Objective</b>
Acute respiratory distress syndrome (ARDS) is an acute and lethal clinical
syndrome that is characterized by the
injury of alveolar
epithelium, which impairs active fluid transport in the
lung, and impedes the reabsorption of
edema fluid from the alveolar space. This
review aimed to discuss the
role of pro-resolving mediators on the
regulation of alveolar fluid clearance (AFC) in ARDS.</p><p><b>
Data Sources</b>Articles published up to September 2017 were selected from the
PubMed, with the
keywords of "alveolar fluid clearance" or "
lung edema" or "
acute lung injury" or "
acute respiratory distress syndrome", and "specialized pro-resolving mediators" or "
lipoxin" or "resolvin" or "
protectin" or "maresin" or "
alveolar epithelial cells" or "
aspirin-triggered
lipid mediators" or "
carbon monoxide and
heme oxygenase" or "
annexin A1".</p><p><b>Study Selection</b>We included all relevant articles published up to September 2017, with no limitation of study design.</p><p><b>Results</b>Specialized pro-resolving mediators (SPMs), as the proinflammatory mediators, not only upregulated
epithelial sodium channel, Na,K-
ATPase,
cystic fibrosis transmembrane conductance regulator (CFTR), and
aquaporins levels, but also improved Na,K-
ATPase activity to promote AFC in ARDS. In addition to the direct effects on
ion channels and
pumps of the alveolar
epithelium, the SPMs also inhibited the inflammatory
cytokine expression and improved the
alveolar epithelial cell repair to enhance the AFC in ARDS.</p><p><b>Conclusions</b>The present
review discusses a novel mechanism for
pulmonary edema fluid reabsorption. SPMs might provide new opportunities to design "reabsorption-targeted"
therapies with high degrees of precision in controlling ALI/ARDS.</p>