Oligomeric proanthocyanidins mitigate acute lung injury by inhibiting NETs and inflammation via the gut-lung axis

Acute lung injury is a common complication of sepsis and characterized by a high mortality rate during hospitalization. Proanthocyanidin, which are abundant compounds found in various plants, have shown promising effects in preventing chronic diseases, and their oligomers have attracted attention for their high bioavailability and strong antioxidant activity. In recent years, there have been suggestions that oligomeric proanthocyanidin may possess lung-protective properties, however, the specific mechanisms involved have not been fully elucidated. This study reveals that the therapeutic efficacy of oligomeric proanthocyanidin in mitigating lung injury during sepsis, achieved through the reduction of neutrophil extracellular traps accumulation and the attenuation of inflammation, can be attributed to the capacity to safeguard the integrity of the intestinal mucus layer and the intestinal barrier. This protective action results in a decrease in endotoxin entry into the bloodstream and bacterial translocation, both of which can trigger neutrophil extracellular traps causing further lung injury.