EPIDEMIOLOGY AND INFLAMMATORY RESPONSES IN ACUTE LUNG INJURY

急性肺损伤的流行病学和炎症反应

• 批准号: 6302180
• 负责人: LEONARD D HUDSON
• 金额: $ 19.99万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-12-01 至 2000-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6302180
• 关键词: adult respiratory distress syndrome; clinical research; diagnostic respiratory lavage; disease /disorder proneness /risk; genetic susceptibility; human subject; immunogenetics; inflammation; lung injury; outcomes research; pathologic process; prognosis; respiratory disorder epidemiology; respiratory epithelium

Problem. Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) continue to be a major cause of morbidity and mortality in critically ill patients. Despite recent advances, major questions remain about ways to identify patients at the highest risk for ALI/ARDS, the true incidence and prevalence of ALI/ARDS, the critical factors involved in the pathogenesis of ALI/ARDS, and individual host factors that influence whether patients develop ALI/ARDS. Specific Aims. The specific aims are: 1) to develop clinical prediction tools that provide individual risk assessment for the onset and outcome of lung injury; 2) to determine the incidence and outcome of ALI/ARDS in populations beyond a single institutions; 3) to determine the relationship between inflammatory responses and injury to the lung endothelial and epithelial barriers; and 4) to investigate determinants of host susceptibility that modulate the occurrence of ALI/ARDS in patients at risk. Experimental Approach. We will build on our experience studying the epidemiology of ARDS at Harborview Medical Center and expand our scope to study a population based cohort in King County WA. We will link data from computerized ICU records at 7 national hospitals to construct a detailed database on ALI/ARDS patients. These data, and the resources of the 13 year Seattle SCOR ARDS Registry, will be used to derive and validate clinical prediction tools for lung injury and onset and mortality; and to describe the population incidence and outcomes of lung injury. We will continue to investigate inflammatory responses in the lungs of patients before and after the onset of ARDS, and determine the relationship between inflammatory responses and injury to the endothelial and epithelial barriers of the lungs. Finally, we will investigate genetically determined host factors that might contribute to susceptibility to ALI/ARDS. Importance of the data. These studies will improve our understanding of 1) the epidemiology of ALI and ARDS; 2) the magnitude of the problem (including incidence, mortality, economic burden, and morbidity in survivors) in a population which we believe will be generalizable to the U.S.; 3) the relationship between inflammatory responses and lung injury; and 4) host factors that may modify susceptibility to lung injury.

问题。急性肺损伤（ALI）和急性呼吸窘迫综合征 （ARDS）仍然是发病率和死亡率的主要原因 危重病人。尽管最近取得了进展，但仍然存在重大问题 关于识别 ALI/ARDS 风险最高的患者的方法，真正的 ALI/ARDS 的发生率和患病率是导致 ALI/ARDS 的关键因素 ALI/ARDS 的发病机制以及影响的个体宿主因素 患者是否出现 ALI/ARDS。 具体目标。具体目标是：1）开发临床预测 为疾病的发生和结果提供个人风险评估的工具 肺损伤； 2) 确定 ALI/ARDS 的发生率和结果 超出单一机构的人口； 3）确定关系 炎症反应与肺内皮损伤之间的关系 上皮屏障； 4）研究宿主的决定因素 调节患者 ALI/ARDS 发生的易感性 风险。 实验方法。我们将根据我们的研究经验 Harborview 医疗中心的 ARDS 流行病学，并将我们的范围扩大到 研究华盛顿州金县的人口队列。我们将链接数据 对 7 家全国医院的 ICU 记录进行计算机化，以构建详细的 ALI/ARDS 患者数据库。这些数据以及 13 西雅图 SCOR ARDS 登记处，将用于派生和验证 肺损伤以及发病率和死亡率的临床预测工具；并到 描述肺损伤的人群发病率和结果。我们将 继续研究患者肺部的炎症反应 ARDS 发病前后，并确定之间的关系 炎症反应以及内皮和上皮细胞损伤 肺部的屏障。最后，我们将研究基因决定的 可能导致 ALI/ARDS 易感性的宿主因素。 数据的重要性。这些研究将增进我们对 1) 的理解 ALI 和 ARDS 的流行病学； 2）问题的严重程度 （包括发病率、死亡率、经济负担和发病率） 幸存者）在我们相信可以推广到的人群中 我们。; 3）炎症反应与肺损伤的关系； 4) 可能改变肺损伤易感性的宿主因素。