Acute Respiratory Distress Syndrome, Acute Respiratory Failure
Conditions
Keywords
ARDS, biomarkers, immunometabolism
Brief summary
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.
Detailed description
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.
Interventions
DIAGNOSTIC_TESTIntegrated Transcriptomics, Metabolomics, and Lipidomics Profiling
Blood samples and BALD samples will be collected for further integrated transcriptomics, metabolomics, lipidomics analysis, and exosome extraction.
Sponsors
Peking Union Medical College Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Aged \>18 years old; 2. Meet the diagnostic criteria of ARDS according to the Berlin Criteria.
Exclusion criteria
1. Aged≤18 years old; 2. Pregnancy; 3. No informed consent;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Identification of ARDS Endotypes | 2 years | 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. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Compare the PBMC and alveolar macrophage derived exosome levels between patients with ARDS and without ARDS | 2 years | Plasma and BLAF supernatant are used for exosome extraction |
| Correlation of Endotypes with published ARDS specific Biomarkers | 2 years | Correlate the endotypes with published markers of hyperinflammatory, microvascular-injury predominant, and distal lung epithelial cell-predominant injury in ARDS |
| Correlation of Endotypes with Intensive care unit-free days | Until 28 days following ICU admission | 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. |
| Correlation of Endotypes with Ventilator-free days | Until 28 days following ICU admission | 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. |
| Correlation of Endotypes with All-cause mortality | Until death or hospital discharge, assessed up to 28 days following ICU admission | — |
Countries
China
Contacts
Primary ContactYingying Yang, MD
Outcome results
None listed