Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research.
Precision medicine in acute respiratory distress syndrome: workshop report and recommendations for future research.
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DOI：
10.1183/16000617.0317-2020
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发表时间：
2021-03-31
期刊：
影响因子：
--
通讯作者：
Calfee CS
中科院分区：
文献类型：
--
作者：
Bos LDJ;Artigas A;Constantin JM;Hagens LA;Heijnen N;Laffey JG;Meyer N;Papazian L;Pisani L;Schultz MJ;Shankar-Hari M;Smit MR;Summers C;Ware LB;Scala R;Calfee CS
急性呼吸窘迫综合征（ARDS）是一种毁灭性的危重病，可由广泛的损伤引发，并仍与约40%的高死亡率相关。对ARDS靶向治疗的研究一直令人失望，可能是由于该综合征的巨大异质性。在欧洲呼吸学会关于“ARDS中的精准医学”的研究研讨会上，我们将总结目前异质性的证据，探索支持精准医学的证据，并为进一步研究ARDS提供路线图。ARDS在病因、生理和生物学三个不同的层次上表现出明显的差异，这使我们得出结论：没有典型的ARDS。缺乏共同的表现意味着对ARDS患者的干预研究需要了解表型，并应用精确的医学方法，以避免我们近几十年来面临的治疗试验缺乏成功。对变异来源进行更深入的表型分析和综合分析，可能会发现代表特定病理生物学机制的其他可治疗性状，或所谓的内型。急性呼吸窘迫综合征（ARDS）在病因学、生理学和生物学三个层次上表现出变异性。缺乏共同的表现意味着对ARDS患者的干预研究需要了解表型并应用精确的医学方法。https://bit.ly/36XZWcP
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. Acute respiratory distress syndrome (ARDS) shows variation on three distinct levels: aetiological, physiological and biological. 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. https://bit.ly/36XZWcP
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影响因子：
76.2
作者：
Calfee, Carolyn S.;Delucchi, Kevin;Parsons, Polly E.;Thompson, B. Taylor;Ware, Lorraine B.;Matthay, Michael A.
通讯作者：
Matthay, Michael A.
影响因子：
24.3
作者：
Cilloniz, Catia;Ferrer, Miquel;Torres, Antoni
通讯作者：
Torres, Antoni
影响因子：
38.9
作者：
Auriemma, Catherine L.;Zhuo, Hanjing;Calfee, Carolyn S.
通讯作者：
Calfee, Carolyn S.
影响因子：
120.7
作者：
Cavalcanti, Alexandre Biasi;Suzumura, Erica Aranha;Ribeiro de Carvalho, Carlos Roberto
通讯作者：
Ribeiro de Carvalho, Carlos Roberto
影响因子：
76.2
作者：
Constantin, Jean-Michel;Jabaudon, Matthieu;Futier, Emmanuel
通讯作者：
Futier, Emmanuel