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In this review, we examine the roles of purine nucleotides and nucleosides and purinergic signaling in acute and chronic pulmonary inflammation, with emphasis on ATP, adenosine diphosphate (ADP), and adenosine ( Acute Respiratory Distress Syndrome Acute respiratory distress syndrome (ARDS), previously known as acute lung injury (ALI), is a life-threatening condition that is a common cause of respiratory failure, morbidity, and mortality in critically ill patients ( 2 O) ( Chronic Lung Diseases Chronic lung diseases, such as asthma, chronic obstructive pulmonary disease (COPD), and idiopathic pulmonary fibrosis (IPF), develop as a result of non-resolvable pulmonary inflammation and dysregulated tissue remodeling that lead to a progressive decline in respiratory function ( The Role of Purinergic Signaling in Acute and Chronic Pulmonary Inflammation Inflammatory and hypoxic conditions lead to increased release of ATP/ADP, which translates to elevated extracellular adenosine levels ( Biology of Purinergic Signaling Extracellular Nucleotide Release and Signaling The roles of purine nucleotides, nucleosides and purinergic signaling in acute and chronic pulmonary inflammation have been studied extensively, with emphasis on ATP, ADP, and adenosine