The Alveolus – understanding the many different visions / versions of the alveolus.


The evolution of the understanding of the lung / alveolus in the last 30 years.

Old textbooks (circa 1970s) mostly offer hand drawings.

Since then, we have an improving understanding that has gone

from a view at the level of the microscope to the electron microscope

to the scanning electron microscope.

What is missing in the literature is giving the clinicians at bedside a

good understanding of the physics and physiology of the lung and the alveolus.


I’ll give one example :

One of the major functions of the lung is an endocrine function : that of

converting Angiotensinogen to Angiotensin.

The lung is the primary place where ACE (angiotensinogen converting enzyme is

located.  The kidney is the secondary place where ACE is found.

What happens to this pulmonary feature of conversion via enzymatic process in the

lung when the lung is significantly atelectatic or the lung is in serious crisis during

a pulmonary edematous event?

Angiotensin is the endogenous hormone that keeps vasculature constricted as the

body deems necessary.

Is it that we as a medical society do not know?

Is it that we do not understand this mechanism of action?

Is it that we have never entertained this notion?