Abstract: The alveolar-capillary barrier (ACB) is essential to maintain the function of gas exchange. Acute respiratory distress syndrome (ARDS), is a critical disease characterized by complex etiology and significant clinical heterogeneity. ARDS is pathologically defined by the impairment of ACB integrity, fundamentally driven by maladaptive between alveolar epithelium and pulmonary endothelium that disrupt their coordinated barrier functions. This article systematically reviews the damage mechanism in ARDS, aiming to provide novel theoretical basis and research direction for clinical therapy optimization strategies and prognosis evaluation of ARDS. Keywords: acute respiratory distress syndrome, alveolar-capillary barrier, alveolar epithelial cells, pulmonary vascular endothelial cells, mechanism, dysfunction
Shi et al. (2026) studied this question.