Acute respiratory distress syndrome (ARDS) is a life-threatening condition that causes high mortality (41% to 58%). Previous studies have reported that biomarkers can facilitate phenotypic diagnosis of ARDS, enabling precision treatment of ARDS. Although there were many studies that found some potential therapeutic targets for ARDS, no pharmacotherapies have been validated to treat ARDS. The development of biomarkers to predict the prognosis and monitor the response to treatment would be of interest for selecting patients for specific therapeutic trials. Many recent studies have shown that immune metabolic changes are involved in the pathogenesis of ARDS and may become a new therapeutic target for them. We aimed to identify a panel of immunometabolic and lipidomic biomarkers derived from blood and bronchoalveolar lavage fluid (BALF) which may help differentiate the ARDS endotypes.
PROTOCOL OUTLINE: This is an observational study. The blood and BALF samples will be collected from patients with ARDS for exosome extraction and transcriptome and metabolomic analysis. Exosome characterization and differential genes and metabolites will be identified.
Study Type
OBSERVATIONAL
Enrollment
200
Blood samples and BALD samples will be collected for further integrated transcriptomics, metabolomics, lipidomics analysis, and exosome extraction.
PUMC
Beijing, Beijing Municipality, China
RECRUITINGYingying Yang
Beijing, Beijing Municipality, China
RECRUITINGIdentification of ARDS Endotypes
Blood samples will be collected on day 1, 3, 5,7 since ARDS diagnosis is made (day 0) and BALF samples will be collected on day 1 and day 7. Blood samples are used to extract PBMC and BALF samples are used to extract alveolar macrophage. Afterwards, PBMC and alveolar macrophage are saved for further transcriptomic and metabomic analysis. At the same time, clinical and biological date are collected to identify subgroups of patients that might share mortality risk, clinical course, and/or treatment responsiveness. At last, the relationship between transcriptomic and metabomic signature of PBMC and alveolar macrophage and the clinical phenotypes are analyzed to determine ARDS endotypes.
Time frame: 2 years
Compare the PBMC and alveolar macrophage derived exosome levels between patients with ARDS and without ARDS
Plasma and BLAF supernatant are used for exosome extraction
Time frame: 2 years
Correlation of Endotypes with published ARDS specific Biomarkers
Correlate the endotypes with published markers of hyperinflammatory, microvascular-injury predominant, and distal lung epithelial cell-predominant injury in ARDS
Time frame: 2 years
Correlation of Endotypes with Intensive care unit-free days
Intensive care unit-free days are calculated by the number of days in the first 28 days following ICU admission that a patient is alive and not in the intensive care unit.
Time frame: Until 28 days following ICU admission
Correlation of Endotypes with Ventilator-free days
Ventilator-free days are calculated by the number of days in the first 28 days following ICU admissionthat a patient is alive and not on a ventilator.
Time frame: Until 28 days following ICU admission
Correlation of Endotypes with All-cause mortality
Time frame: Until death or hospital discharge, assessed up to 28 days following ICU admission
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