A narrative review on the future of ARDS: evolving definitions, pathophysiology, and tailored management

Critical Care, Journal Year: 2025, Volume and Issue: 29(1)

Published: Feb. 24, 2025

Acute respiratory distress syndrome (ARDS) is a severe complication of critical illness, characterized by bilateral lung infiltrates and hypoxemia. Its clinical pathophysiological heterogeneity poses challenges for both diagnosis treatment. This review outlines the evolution ARDS definitions, discusses underlying pathophysiology ARDS, examines implications its heterogeneity. Traditional definitions required invasive mechanical ventilation relied on arterial blood gas measurements to calculate PaO2/FiO2 ratio. Recent updates have expanded these criteria include patients receiving noninvasive support, such as high-flow nasal oxygen, adoption SpO2/FiO2 ratio an alternative While changes broaden diagnostic criteria, they also introduce additional complexity. heterogeneity—driven varying etiologies, subphenotypes, biological mechanisms—highlights limitations uniform management approach. Emerging evidence highlights presence distinct each defined unique molecular characteristics, offering pathway more precise therapeutic targeting. Advances in omics technologies—encompassing genomics, proteomics, metabolomics—are paving way precision-medicine approaches with potential revolutionize tailoring interventions individual patient profiles. paradigm shift from broad categories precise, subphenotype-driven care holds promise redefining landscape treatment and, ultimately, improving outcomes this complex, multifaceted syndrome.

Language: Английский

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Advances in nanomaterial-targeted treatment of acute lung injury after burns

Journal of Nanobiotechnology, Journal Year: 2024, Volume and Issue: 22(1)

Published: June 18, 2024

Abstract Acute lung injury ( ALI ) is a common complication in patients with severe burns and has complex pathogenesis high morbidity mortality rates. A variety of drugs have been identified the clinic for treatment ALI, but they toxic side effects caused by easy degradation body distribution throughout body. In recent years, as understanding mechanism underlying improved, scholars developed new nanomaterials that can be safely effectively targeted ALI. Most these methods involve such lipids, organic polymers, peptides, extracellular vesicles or cell membranes, inorganic nanoparticles other nanomaterials, which are to reach tissues perform their functions through active targeting passive targeting, process involves cells organelles. this review, first, mechanisms pathophysiological features occurrence after burn reviewed, potential therapeutic targets summarized, existing classified, possible problems challenges discussed provide reference development

Language: Английский

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Extracellular histones promote TWIK2-dependent potassium efflux and associated NLRP3 activation in alveolar macrophages during sepsis-induced lung injury

Inflammation Research, Journal Year: 2024, Volume and Issue: 73(7), P. 1137 - 1155

Published: May 11, 2024

Language: Английский

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Modified Xiao-Qing-Long-decoction prevents inflammation and promotes Nur77 expression in mice with acute respiratory distress syndrome by inhibiting HDAC7 expression

Pharmaceutical Biology, Journal Year: 2025, Volume and Issue: 63(1), P. 110 - 117

Published: Feb. 4, 2025

Context Modified Xiao-Qing-Long-decoction (MXQLD) is believed to have the potential alleviate lung diseases.

Language: Английский

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Immune dysregulation in COVID-19 induced ARDS in kidney transplant recipients revealed by single-cell RNA sequencing

Scientific Reports, Journal Year: 2025, Volume and Issue: 15(1)

Published: Feb. 26, 2025

Since the emergence of COVID-19 at end 2019, disease has led to widespread acute respiratory distress syndrome (ARDS), particularly among kidney transplant recipients (KTRs), who are increased risk due long-term immunosuppressive therapy. This study aims explore differences in immune responses between and non-kidney COVID-19-induced ARDS identify potential therapeutic targets for improving outcomes. Single-cell RNA sequencing was performed on 108,320 cells derived from peripheral blood samples construct a global single-cell map induced recipients(ARDSKT), non recipients(ARDSNKT), healthy controls. Subsequently, using cellular clustering analysis, we obtained maps different cell types. We employed enrichment analysis determine pathways involved subpopulations focused role key such as monocytes, megakaryocytes, B cells, CD8+ T pathogenesis ARDS. Significant were observed ARDSKT ARDSNKT. In ARDSKT, S100A9+ MK subpopulation, which activates NF-κB signaling pathway, elevated, promoting inflammation. contrast, S100A12+ monocyte subpopulation that chemokine pathway more abundant ARDSNKT, reflecting stronger inflammatory response, while its abundance reduced immunosuppression. The CXCR4+ crucial adaptive immunity, significantly ARDSKT. Additionally, XAF1+ Teff associated with apoptosis, potentially impairing recovery. highlights revealing impact immunosuppression dysregulation. These findings suggest targeting specific can improve strategies

Language: Английский

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Dynamic Immune Indicator Changes as Predictors of ARDS in ICU Patients with Sepsis: A Retrospective Study

International Journal of General Medicine, Journal Year: 2025, Volume and Issue: Volume 18, P. 1163 - 1172

Published: Feb. 28, 2025

Understanding the dynamic changes in immune indicators during sepsis and their predictive value for Acute respiratory distress syndrome (ARDS) is crucial improving patient outcomes. This single-center, observational retrospective study was conducted at Lishui Central Hospital, Zhejiang Province. Patients diagnosed with Sepsis-3 were categorized into non-ARDS ARDS groups based on development. Data collection included demographics, clinical data, parameters. Immune parameters collected days 1, 3, 7 post-admission. Multivariate logistic regression analysis identified independent risk factors ARDS, a nomogram model constructed. The ability of evaluated using ROC curves. key nomogram, including CD4, CD8, Treg, lymphocyte, IgG, IgA levels Days 3 7. On Day CD8 (P < 0.001), Tregs = 0.021), IgG 0.001) showed significant negative correlations 7, CD4 lymphocyte count similarly demonstrated risk. had an AUC 0.998 (95% CI: 0.997-0.999), indicating high ability. Early indicators, IgA, Lymphocyte, predict development ICU patients.

Language: Английский

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Therapeutic Effects of TN13 Peptide on Acute Respiratory Distress Syndrome and Sepsis Models In Vivo

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(6), P. 1804 - 1804

Published: March 7, 2025

Background/Objectives: Regulation of acute inflammatory responses is crucial for host mortality and morbidity induced by pathogens. The pathogenesis respiratory distress syndrome (ARDS) sepsis are associated with systemic inflammation. p38 MAPK a regulator potential target diseases, including ARDS sepsis. We investigated the therapeutic effects TAT-TN13 peptide (TN13) on severe sepsis, in vivo. Methods: To establish model, C57BL/6 mice were intranasally (i.n.) administered lipopolysaccharide (LPS; 5 mg/kg, 40 µL) to induce lung As positive control, dexamethasone (DEX; 0.2 mg/kg) was intraperitoneally 1 h post-LPS exposure. In experimental groups, TN13 at doses 2.5 mg or mg/kg same time point. LPS-induced received an intraperitoneal injection LPS (20 (25 i.p.) after treatment. Control phosphate-buffered saline (PBS). Lung histopathology, cell infiltration, cytokine levels, survival rates assessed evaluate efficacy. Results: significantly reduced recruitment production lungs, thereby mitigating ARDS. treatment improved suppressing responses. Mechanistically, exerted its inhibiting MAPK/NF-κB signaling pathway. Conclusions: These results collectively suggested that could be effective option diseases.

Language: Английский

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Dexmedetomidine administration is associated with reduced mortality in patients with sepsis-induced acute respiratory distress syndrome: a retrospective study

BMC Anesthesiology, Journal Year: 2025, Volume and Issue: 25(1)

Published: March 10, 2025

Although studies have revealed the benefits of using dexmedetomidine (DEX) in treating rodent models acute lung injury (ALI) by improving their survival rates, clinical investigation on effect DEX patients with respiratory distress syndrome (ARDS) remains scarce. Through this retrospective study, we aim to better understand underlying mechanism sepsis-induced ARDS and patients' standard treatment. A total 208 ARDS, admitted intensive care unit (ICU) at Affiliated Hospital Jiangsu University, China, from January 2017 December 2019, were included. The divided into control group (n = 102) 106). Both groups received mechanical ventilation care; however, was additionally treated as a sedative. Demographic information, baseline characteristics, laboratory parameters, arterial blood gas (ABG) analyses, inflammatory indicators compared between two evaluate therapeutic outcomes different treatment approaches. Age male gender constituted risk factors for high incidence, hypertension led list comorbidities. characteristics including primary diagnosis causes, prognostic values such Acute Physiology Chronic Health Evaluation (APACHE) II score predicted mortality, comparable patients. However, multiple organ dysfunction (MODS) incidence actual mortality rate significantly lower group. Additionally, demonstrated improved ABG metrics, representing acid-base balance oxygenation, enhanced responses. Intravenous administration associated reduced in-hospital least part, ameliorating indices mediators.

Language: Английский

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Screening of mitochondrial-related biomarkers connected with immune infiltration for acute respiratory distress syndrome through WGCNA and machine learning

Medicine, Journal Year: 2025, Volume and Issue: 104(10), P. e41497 - e41497

Published: March 7, 2025

Septic acute respiratory distress syndrome (ARDS) is a complex and noteworthy type, but its molecular mechanism has not been fully elucidated. The aim to explore specific biomarkers diagnose sepsis-induced ARDS. Gene expression data of sepsis alone ARDS were downloaded from public databases, the differential immune cells expressed genes between 2 groups screened. Weighted gene co-expression network analysis was used identify cells-related module genes, then integrated with mitochondrial obtain common genes. Next, least absolute shrinkage selection operator, random forest, support vector machine-recursive feature elimination utilized construct nomogram model. Meanwhile, biological function targeted drugs analyzed. abundance 3 (macrophage, neutrophils, monocytes) significantly different groups. machine learning identified 5 up-regulated in had diagnostic significance. based on these good confidence clinical application value. set enrichment showed that phenylalanine metabolism pathway increased samples positive correlation Drug prediction exhibited chlorzoxazone, ajmaline, clindamycin could target multiple Overall, signature screened this study can effectively predict possibility patients, which deepen understanding pathogenesis therapy development.

Language: Английский

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Identifying potential drug targets for sepsis-related adult respiratory distress syndrome through comprehensive genetic analysis and druggability assessment

Journal of Global Health, Journal Year: 2025, Volume and Issue: 15

Published: March 21, 2025

Abstract Background Sepsis-related adult respiratory distress syndrome (ARDS) is a life-threatening condition characterised by high mortality rate. This underscores the pressing requirement to identify and develop potential therapeutic targets for severe condition. study investigated genetic predisposition sepsis-related ARDS in this study. Methods We utilised summary-based Mendelian randomisation (SMR), two-sample MR (TSMR), mediating MR, multivariate (MVMR) analysis explore susceptibility of integrating over 10 000 cis-expression quantitative trait loci (cis-eQTLs) 100 participants. Subsequently, we performed drug target potentially druggable cis-eQTL genes. Results The SMR identified 677 genes associated with sepsis. Further TSMR validation filtered 72 causally Sepsis was (beta = 1.80, standard error (SE) 0.36, P < 0.001). After conducting MVMR analysis, 50 were reported be ARDS. Subsequent confirmed role four (PSMA4, PDK2, RPS18, NDUFV3) as Conclusions Through an extensive Additional research imperative substantiate our discoveries pave way development novel pharmaceuticals aimed at these specific targets.

Language: Английский

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