Show simple item record

dc.contributor.authorWildi, K
dc.contributor.authorLivingstone, S
dc.contributor.authorPalmieri, C
dc.contributor.authorLiBassi, G
dc.contributor.authorSuen, J
dc.contributor.authorFraser, J
dc.date.accessioned2021-03-11T04:00:00Z
dc.date.available2021-03-11T04:00:00Z
dc.date.issued2021
dc.identifier.issn2052-0492
dc.identifier.doi10.1186/s40560-021-00528-w
dc.identifier.urihttp://hdl.handle.net/10072/403071
dc.description.abstractThe acute respiratory distress syndrome (ARDS) is a severe lung disorder with a high morbidity and mortality which affects all age groups. Despite active research with intense, ongoing attempts in developing pharmacological agents to treat ARDS, its mortality rate remains unaltered high and treatment is still only supportive. Over the years, there have been many attempts to identify meaningful subgroups likely to react differently to treatment among the heterogenous ARDS population, most of them unsuccessful. Only recently, analysis of large ARDS cohorts from randomized controlled trials have identified the presence of distinct biological subphenotypes among ARDS patients: a hypoinflammatory (or uninflamed; named P1) and a hyperinflammatory (or reactive; named P2) subphenotype have been proposed and corroborated with existing retrospective data. The hyperinflammatory subphenotyope was clearly associated with shock state, metabolic acidosis, and worse clinical outcomes. Core features of the respective subphenotypes were identified consistently in all assessed cohorts, independently of the studied population, the geographical location, the study design, or the analysis method. Additionally and clinically even more relevant treatment efficacies, as assessed retrospectively, appeared to be highly dependent on the respective subphenotype. This discovery launches a promising new approach to targeted medicine in ARDS. Even though it is now widely accepted that each ARDS subphenotype has distinct functional, biological, and mechanistic differences, there are crucial gaps in our knowledge, hindering the translation to bedside application. First of all, the underlying driving biological factors are still largely unknown, and secondly, there is currently no option for fast and easy identification of ARDS subphenotypes. This narrative review aims to summarize the evidence in biological subphenotyping in ARDS and tries to point out the current issues that will need addressing before translation of biological subohenotypes into clinical practice will be possible.
dc.description.peerreviewedYes
dc.languageen
dc.publisherSpringer Science and Business Media LLC
dc.relation.ispartofissue1
dc.relation.ispartofjournalJournal of Intensive Care
dc.relation.ispartofvolume9
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchcode3202
dc.titleThe discovery of biological subphenotypes in ARDS: a novel approach to targeted medicine?
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationWildi, K; Livingstone, S; Palmieri, C; LiBassi, G; Suen, J; Fraser, J, The discovery of biological subphenotypes in ARDS: a novel approach to targeted medicine?, Journal of Intensive Care, 2021, 9 (1)
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.date.updated2021-03-11T03:23:30Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© The Author(s), 2021. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
gro.hasfulltextFull Text
gro.griffith.authorFraser, John F.


Files in this item

This item appears in the following Collection(s)

  • Journal articles
    Contains articles published by Griffith authors in scholarly journals.

Show simple item record