Phenotypic Diversity in Acute Respiratory Distress Syndrome
Summary
Acute Respiratory Distress Syndrome (ARDS) represents a severe form of respiratory failure characterised by diffuse alveolar damage, permeability oedema and refractory hypoxaemia. Heterogeneity in clinical presentation, biological markers and response to treatment has prompted investigation into distinct ARDS phenotypes. Recognising phenotypic diversity has refined our understanding of underlying mechanisms, enabling stratification based on inflammatory profiles, origin of lung injury or molecular signatures. Two principal subgroups have emerged in adult cohorts: a hyperinflammatory phenotype with elevated cytokines, greater endothelial and epithelial injury and higher mortality, and a hypoinflammatory phenotype with more modest biomarker elevations and better outcomes. Beyond adult studies, paediatric ARDS exhibits distinct immunopathology, with trajectories of inflammatory mediators and tissue-injury markers correlating with persistence of organ dysfunction. Delineation of phenotypes guides targeted therapies, informs trial design and offers a framework for precision medicine in critical care, with the ultimate aim of improving global outcomes through tailored interventions.
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Phenotypic Diversity in Acute Respiratory Distress Syndrome publication trend
The graph below shows the total number of articles in phenotypic diversity in acute respiratory distress syndrome across all publications each year (not limited to Nature Index journals).
Technical terms
Phenotype: A set of observable characteristics or traits of a disease reflecting underlying biological processes.
Latent class analysis: A statistical method that identifies unobserved subgroupings within heterogeneous patient populations based on patterns in multivariable data.
Biomarker trajectory: The pattern of change in a biological marker over time, used to infer disease progression or response to treatment.
Hyperinflammatory phenotype: An ARDS subgroup marked by excessive systemic inflammation, endothelial and epithelial injury, and higher mortality risk.
References
- Inflammatory and tissue injury marker dynamics in pediatric acute respiratory distress syndrome. Journal of Clinical Investigation (2024).
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