title: A Pathophysiologic Approach to Biomarkers in Acute Respiratory Distress Syndrome.
abstract: Acute respiratory distress syndrome (ARDS) is an acute-onset hypoxic condition with radiographic bilateral lung infiltration. It is characterized by an acute exudative phase combining diffuse alveolar damage and lung edema followed by a later fibroproliferative phase. Despite an improved understanding of ARDS pathobiology, our ability to predict the development of ARDS and risk-stratify patients with the disease remains limited. Biomarkers may help to identify patients at the highest risk of developing ARDS, assess response to therapy, predict outcome, and optimize enrollment in clinical trials. After a short description of ARDS pathobiology, here, we review the scientific evidence that supports the value of various ARDS biomarkers with regard to their major biological roles in ARDS-associated lung injury and/or repair. Ongoing research aims at identifying and characterizing novel biomarkers, in order to highlight relevant mechanistic explorations of lung injury and repair, and to ultimately develop innovative therapeutic approaches for ARDS patients. This review will focus on the pathophysiologic, diagnostic, and therapeutic implications of biomarkers in ARDS and on their utility to ultimately improve patient care.
authors.affiliation: CHU Clermont-Ferrand, Intensive Care Unit, Department of Perioperative Medicine, Estaing University Hospital, 63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, EA 7281, R2D2, 63000 Clermont-Ferrand, France.
authors.forename: Raiko
authors.initials: R
authors.lastname: Blondonnet
authors.affiliation: CHU Clermont-Ferrand, Intensive Care Unit, Department of Perioperative Medicine, Estaing University Hospital, 63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, EA 7281, R2D2, 63000 Clermont-Ferrand, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Constantin
authors.affiliation: Clermont Université, Université d'Auvergne, EA 7281, R2D2, 63000 Clermont-Ferrand, France; Department of Medical Biochemistry and Molecular Biology, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Sapin
authors.affiliation: CHU Clermont-Ferrand, Intensive Care Unit, Department of Perioperative Medicine, Estaing University Hospital, 63000 Clermont-Ferrand, France; Clermont Université, Université d'Auvergne, EA 7281, R2D2, 63000 Clermont-Ferrand, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Jabaudon
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D011379:Prognosis; D012128:Respiratory Distress Syndrome / Q000378:metabolism / Q000503:physiopathology*
chemical_list: D015415:Biomarkers