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Adult respiratory distress syndrome

Large-scale Proteomic Profiling Identifies Distinct Inflammatory Phenotypes in Acute Respiratory Distress Syndrome

Strategic Insights

— 1 min read

Researchers at Fudan University in Shanghai, China have made a significant breakthrough in understanding the complexities of acute respiratory distress syndrome (ARDS). By conducting a multicenter cohort study with 1048 patients, they were able to identify three distinct inflammatory phenotypes (C1, C2, C3) using targeted serum proteomics. The study found that patients with phenotype C1, characterized by poorly/non-inflated lung compartments, had the highest 90-day mortality, shock incidence, and fewest ventilator-free days. In contrast, patients with phenotype C2 had the best outcomes.

Key Takeaways:

  • The study identified three distinct inflammatory phenotypes in ARDS, including C1, C2, and C3, using targeted serum proteomics.
  • Phenotype C1, characterized by poorly/non-inflated lung compartments, had the highest 90-day mortality, shock incidence, and fewest ventilator-free days.
  • Patients with phenotype C2 had the best outcomes, suggesting a potential biomarker-driven strategy for precision medicine in ARDS.
  • The study highlights the importance of heterogeneous treatment effects (HTEs) for glucocorticoids and ventilation strategies in ARDS.
  • A multinomial XGBoost model was developed to classify phenotypes, demonstrating the potential of machine learning-based radiomics for phenotypic distinctions.
  • The research was funded by the National Natural Science Foundation of China, Shanghai Municipal Health Commission, National Key Research and Development Program of China, and Science and Technology Commission of Shanghai Municipality.

Statistics:

  • 1048 patients participated in the multicenter cohort study.
  • 3 distinct inflammatory phenotypes (C1, C2, C3) were identified using targeted serum proteomics.
  • 72 hours was the time frame for serum sample collection to capture early-stage profiles.
  • 2 independent cohorts were used to validate the findings, including 500 patients in the first cohort and 548 patients in the second cohort.
  • Lung CT scans were analyzed using machine learning-based radiomics to explore phenotypic distinctions.
  • Heterogeneous treatment effects (HTEs) for glucocorticoids and ventilation strategies were evaluated using inverse probability of treatment weighting (IPTW) adjusted Cox regression.

Sources:

  • European Respiratory Journal, 2025:2500933 (Large-scale proteomic profiling identifies distinct inflammatory phenotypes in Acute Respiratory Distress Syndrome (ARDS): A multi-center, prospective cohort study)
  • NewsRx. Findings from Fudan University in the Area of Respiratory Distress Syndrome Described [Large-scale proteomic profiling identifies distinct inflammatory phenotypes in Acute Respiratory Distress Syndrome (ARDS): A multi-center, prospective cohort ...]. Respiratory Therapeutics Week. October 20, 2025; p 949.

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