Molecular and Immune Biomarkers in Acute Respiratory Distress Syndrome A Perspective From Members of the Pulmonary Pathology Society
Molecular and Immune Biomarkers in Acute Respiratory Distress Syndrome A Perspective From Members of the Pulmonary Pathology Society
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DOI：
10.5858/arpa.2017-0115-sa
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发表时间：
2017-12-01
影响因子：
4.6
通讯作者：
Smith, Maxwell Lawrence
中科院分区：
文献类型：
--
作者：
Capelozzi, Vera Luiza;Allen, Timothy Craig;Smith, Maxwell Lawrence
急性呼吸窘迫综合征（ARDS）是一种发病率和死亡率较高的多因素综合征，其特征是气体交换和肺力学缺陷，导致低氧血症、呼吸困难和呼吸衰竭。在组织学上，ARDS 的特征是急性渗出期，结合弥漫性肺泡损伤和非心源性水肿，随后是纤维增殖期。尽管对 ARDS 发病机制的了解有所增强，但预测 ARDS 发展和对该疾病患者进行风险分层的能力仍然有限。生物标志物可能有助于识别发生 ARDS 风险最大的患者、评估治疗反应、预测结果并改进临床试验。本文介绍了 ARDS 的发病机制，以及目前临床上使用或可供学术和执业病理学家实验室使用的生物标志物的概念和信息，以及新检测方法的开发和验证，重点关注检测方法在肺损伤和/或修复中的主要生物学作用，并最终提出创新的治疗方法。
Acute respiratory distress syndrome (ARDS) is a multifactorial syndrome with high morbidity and mortality rates, characterized by deficiency in gas exchange and lung mechanics that lead to hypoxemia, dyspnea, and respiratory failure. Histologically, ARDS is characterized by an acute, exudative phase, combining diffuse alveolar damage and noncardiogenic edema, followed by a later fibroproliferative phase. Despite an enhanced understanding of ARDS pathogenesis, the capacity to predict the development of ARDS and to risk-stratify patients with the disease remains limited. Biomarkers may help to identify patients at the greatest risk of developing ARDS, to evaluate response to therapy, to predict outcome, and to improve clinical trials. The ARDS pathogenesis is presented in this article, as well as concepts and information on biomarkers that are currently used clinically or are available for laboratory use by academic and practicing pathologists and the developing and validating of new assays, focusing on the assays' major biologic roles in lung injury and/or repair and to ultimately suggest innovative, therapeutic approaches.