Fig. 8: Model of LCWE-induced ALI.

In macrophage cells, LCWE activates inflammatory signaling pathways through TLR2, unlike LPS through TLR4. MYD88 functions as the adaptor for the TLR receptors of both LCWE and LPS, activating the NF-κB signaling pathway and the expression of inflammatory cytokines including IL6, TNFα, pro-IL-1β, and NLRP3. These cytokines further increase inflammatory signaling, resulting in an inflammatory storm and ALI.