|
KMID : 1044520240870010001
|
|
Tuberculosis and Respiratory Diseases
2024 Volume.87 No. 1 p.1 ~ p.11
|
|
|
Subphenotypes of Acute Respiratory Distress Syndrome: Advancing towards Precision Medicine
|
|
Andrea R. Levine
Carolyn S. Calfee
|
|
|
Abstract
|
|
|
Acute respiratory distress syndrome (ARDS) is a common cause of severe hypoxemiadefined by the acute onset of bilateral non-cardiogenic pulmonary edema. The diagnosisis made by defined consensus criteria. Supportive care, including prevention offurther injury to the lungs, is the only treatment that conclusively improves outcomes.
The inability to find more advanced therapies is due, in part, to the highly sensitive butrelatively non-specific current syndromic consensus criteria, combining a heterogenouspopulation of patients under the umbrella of ARDS. With few effective therapies,the morality rate remains 30% to 40%. Many subphenotypes of ARDS have been proposedto cluster patients with shared combinations of observable or measurable traits.
Subphenotyping patients is a strategy to overcome heterogeneity to advance clinicalresearch and eventually identify treatable traits. Subphenotypes of ARDS have beenproposed based on radiographic patterns, protein biomarkers, transcriptomics, and/ormachine-based clustering of clinical and biological variables. Some of these strategieshave been reproducible across patient cohorts, but at present all have practical limitationsto their implementation. Furthermore, there is no agreement on which strategy isthe most appropriate. This review will discuss the current strategies for subphenotypingpatients with ARDS, including the strengths and limitations, and the future directionsof ARDS subphenotyping.
|
|
|
KEYWORD
|
|
|
Acute Respiratory Distress Syndrome, Phenotype, Subphenotype
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|