The Pulmonary Circadian Rhythms (Diurnal Rhythms) Role of the Bmal1/Per2 Axis in Mitigating Ventilator-Induced Lung Injury and Fibrosis through Nrf2 Antioxidant Pathway Activation

De-chao Li

doi:10.1016/j.ejphar.2026.178929

The Pulmonary Circadian Rhythms (Diurnal Rhythms) Role of the Bmal1/Per2 Axis in Mitigating Ventilator-Induced Lung Injury and Fibrosis through Nrf2 Antioxidant Pathway Activation

2026-05-05

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De-chao Li

M

Ming-hui Wu

H

Hongyan Ruan *

DOI：10.1016/j.ejphar.2026.178929

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While lung-protective ventilation strategies are standard care, effective adjunctive pharmacotherapies for ventilator-induced lung injury (VILI) remain lacking. Disruption of circadian (diurnal) rhythms is implicated in various lung pathologies, and the exploration of circadian regulation in VILI has emerged as a clinically relevant research direction for optimizing mechanical ventilation strategies. We hypothesized that the pulmonary Bmal1/Per2 axis confers protection against VILI by activating the Nrf2 antioxidant pathway.

Keywords:

Bmal1

Per2

Ventilator-induced lung injury

Nrf2

Circadian rhythms

The Pulmonary Circadian Rhythms (Diurnal Rhythms) Role of the Bmal1/Per2 Axis in Mitigating Ventilator-Induced Lung Injury and Fibrosis through Nrf2 Antioxidant Pathway Activation

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