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Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research

Acute respiratory distress syndrome (ARDS) is a devastating critical illness that can be triggered by a wide range of insults and remains associated with a high mortality of around 40%. The search for targeted treatment for ARDS has been disappointing, possibly due to the enormous heterogeneity with...

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Autores principales: Bos, Lieuwe D.J., Artigas, Antonio, Constantin, Jean-Michel, Hagens, Laura A., Heijnen, Nanon, Laffey, John G., Meyer, Nuala, Papazian, Laurent, Pisani, Lara, Schultz, Marcus J., Shankar-Hari, Manu, Smit, Marry R., Summers, Charlotte, Ware, Lorraine B., Scala, Raffaele, Calfee, Carolyn S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: European Respiratory Society 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522998/
https://www.ncbi.nlm.nih.gov/pubmed/33536264
http://dx.doi.org/10.1183/16000617.0317-2020
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author Bos, Lieuwe D.J.
Artigas, Antonio
Constantin, Jean-Michel
Hagens, Laura A.
Heijnen, Nanon
Laffey, John G.
Meyer, Nuala
Papazian, Laurent
Pisani, Lara
Schultz, Marcus J.
Shankar-Hari, Manu
Smit, Marry R.
Summers, Charlotte
Ware, Lorraine B.
Scala, Raffaele
Calfee, Carolyn S.
author_facet Bos, Lieuwe D.J.
Artigas, Antonio
Constantin, Jean-Michel
Hagens, Laura A.
Heijnen, Nanon
Laffey, John G.
Meyer, Nuala
Papazian, Laurent
Pisani, Lara
Schultz, Marcus J.
Shankar-Hari, Manu
Smit, Marry R.
Summers, Charlotte
Ware, Lorraine B.
Scala, Raffaele
Calfee, Carolyn S.
author_sort Bos, Lieuwe D.J.
collection PubMed
description Acute respiratory distress syndrome (ARDS) is a devastating critical illness that can be triggered by a wide range of insults and remains associated with a high mortality of around 40%. The search for targeted treatment for ARDS has been disappointing, possibly due to the enormous heterogeneity within the syndrome. In this perspective from the European Respiratory Society research seminar on “Precision medicine in ARDS”, we will summarise the current evidence for heterogeneity, explore the evidence in favour of precision medicine and provide a roadmap for further research in ARDS. There is evident variation in the presentation of ARDS on three distinct levels: 1) aetiological; 2) physiological and 3) biological, which leads us to the conclusion that there is no typical ARDS. The lack of a common presentation implies that intervention studies in patients with ARDS need to be phenotype aware and apply a precision medicine approach in order to avoid the lack of success in therapeutic trials that we faced in recent decades. Deeper phenotyping and integrative analysis of the sources of variation might result in identification of additional treatable traits that represent specific pathobiological mechanisms, or so-called endotypes.
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spelling pubmed-85229982021-10-18 Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research Bos, Lieuwe D.J. Artigas, Antonio Constantin, Jean-Michel Hagens, Laura A. Heijnen, Nanon Laffey, John G. Meyer, Nuala Papazian, Laurent Pisani, Lara Schultz, Marcus J. Shankar-Hari, Manu Smit, Marry R. Summers, Charlotte Ware, Lorraine B. Scala, Raffaele Calfee, Carolyn S. Eur Respir Rev Reviews Acute respiratory distress syndrome (ARDS) is a devastating critical illness that can be triggered by a wide range of insults and remains associated with a high mortality of around 40%. The search for targeted treatment for ARDS has been disappointing, possibly due to the enormous heterogeneity within the syndrome. In this perspective from the European Respiratory Society research seminar on “Precision medicine in ARDS”, we will summarise the current evidence for heterogeneity, explore the evidence in favour of precision medicine and provide a roadmap for further research in ARDS. There is evident variation in the presentation of ARDS on three distinct levels: 1) aetiological; 2) physiological and 3) biological, which leads us to the conclusion that there is no typical ARDS. The lack of a common presentation implies that intervention studies in patients with ARDS need to be phenotype aware and apply a precision medicine approach in order to avoid the lack of success in therapeutic trials that we faced in recent decades. Deeper phenotyping and integrative analysis of the sources of variation might result in identification of additional treatable traits that represent specific pathobiological mechanisms, or so-called endotypes. European Respiratory Society 2021-02-03 /pmc/articles/PMC8522998/ /pubmed/33536264 http://dx.doi.org/10.1183/16000617.0317-2020 Text en Copyright ©ERS 2021. https://creativecommons.org/licenses/by-nc/4.0/This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
spellingShingle Reviews
Bos, Lieuwe D.J.
Artigas, Antonio
Constantin, Jean-Michel
Hagens, Laura A.
Heijnen, Nanon
Laffey, John G.
Meyer, Nuala
Papazian, Laurent
Pisani, Lara
Schultz, Marcus J.
Shankar-Hari, Manu
Smit, Marry R.
Summers, Charlotte
Ware, Lorraine B.
Scala, Raffaele
Calfee, Carolyn S.
Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research
title Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research
title_full Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research
title_fullStr Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research
title_full_unstemmed Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research
title_short Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research
title_sort precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research
topic Reviews
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522998/
https://www.ncbi.nlm.nih.gov/pubmed/33536264
http://dx.doi.org/10.1183/16000617.0317-2020
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