• Vipul J Patel, Sreeja Biswas Roy, Hiren J Mehta, Myungsoo Joo, and Ruxana T Sadikot.
• Division of Pulmonology, Norton Thoracic Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
• Biomed Res Int. 2018 Jan 1; 2018: 2476824.

IntroductionAcute respiratory distress syndrome (ARDS) is a complex clinical syndrome characterized by acute inflammation, microvascular damage, and increased pulmonary vascular and epithelial permeability, frequently resulting in acute respiratory failure and death. Current best practice for ARDS involves "lung-protective ventilation," which entails low tidal volumes and limiting the plateau pressures in mechanically ventilated patients. Although considerable progress has been made in understanding the pathogenesis of ARDS, little progress has been made in the development of specific therapies to combat injury and inflammation.Areas CoveredIn recent years, several natural products have been studied in experimental models and have been shown to inhibit multiple inflammatory pathways associated with acute lung injury and ARDS at a molecular level. Because of the pleiotropic effects of these agents, many of them also activate antioxidant pathways through nuclear factor erythroid-related factor 2, thereby targeting multiple pathways. Several of these agents are prescribed for treatment of inflammatory conditions in the Asian subcontinent and have shown to be relatively safe.Expert CommentaryHere we review natural remedies shown to attenuate lung injury and inflammation in experimental models. Translational human studies in patients with ARDS may facilitate treatment of this devastating disease.

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