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Beitler JR, Thompson BT, Baron RM, et al. Advancing precision medicine for acute respiratory distress syndrome. Lancet Respir Med. 2021;doi: 10.1016/S2213-2600(21)00157-0.
Beitler, J. R., Thompson, B. T., Baron, R. M., Bastarache, J. A., Denlinger, L. C., Esserman, L., Gong, M. N., LaVange, L. M., Lewis, R. J., Marshall, J. C., Martin, T. R., McAuley, D. F., Meyer, N. J., Moss, M., Reineck, L. A., Rubin, E., Schmidt, E. P., Standiford, T. J., Ware, L. B., Wong, H. R., Aggarwal, N. R., & Calfee, C. S. (2021). Advancing precision medicine for acute respiratory distress syndrome. The Lancet. Respiratory medicine, . https://doi.org/10.1016/S2213-2600(21)00157-0
Beitler, Jeremy R, et al. "Advancing precision medicine for acute respiratory distress syndrome." The Lancet. Respiratory medicine vol. (2021). doi: https://doi.org/10.1016/S2213-2600(21)00157-0
Beitler JR, Thompson BT, Baron RM, Bastarache JA, Denlinger LC, Esserman L, Gong MN, LaVange LM, Lewis RJ, Marshall JC, Martin TR, McAuley DF, Meyer NJ, Moss M, Reineck LA, Rubin E, Schmidt EP, Standiford TJ, Ware LB, Wong HR, Aggarwal NR, Calfee CS. Advancing precision medicine for acute respiratory distress syndrome. Lancet Respir Med. 2021 Jul 23; doi: 10.1016/S2213-2600(21)00157-0. Epub 2021 Jul 23. PMID: 34310901; PMCID: PMC8302189.
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Lancet Respir Med. 2021 Jul 23; doi: 10.1016/S2213-2600(21)00157-0. Epub 2021 Jul 23.

Advancing precision medicine for acute respiratory distress syndrome.

The Lancet. Respiratory medicine

Jeremy R Beitler, B Taylor Thompson, Rebecca M Baron, Julie A Bastarache, Loren C Denlinger, Laura Esserman, Michelle N Gong, Lisa M LaVange, Roger J Lewis, John C Marshall, Thomas R Martin, Daniel F McAuley, Nuala J Meyer, Marc Moss, Lora A Reineck, Eileen Rubin, Eric P Schmidt, Theodore J Standiford, Lorraine B Ware, Hector R Wong, Neil R Aggarwal, Carolyn S Calfee

Affiliations

  1. Center for Acute Respiratory Failure and Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA.
  2. Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  3. Division of Pulmonary and Critical Care Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
  4. Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
  5. Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
  6. Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
  7. Division of Pulmonary and Critical Care Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, USA.
  8. Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
  9. Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA; Berry Consultants, LLC, Austin, TX; Department of Emergency Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
  10. Departments of Surgery and Critical Care Medicine, University of Toronto, Toronto, Canada.
  11. Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA.
  12. Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast and Regional Intensive Care Unit, Royal Victoria Hospital, Belfast, Northern Ireland.
  13. Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  14. Division of Pulmonary Sciences and Critical Care, University of Colorado School of Medicine, Aurora, CO, USA.
  15. Division of Lung Diseases, National Heart, Lung, and Blood Institute, Bethesda, MD, USA.
  16. ARDS Foundation, Northbrook, IL, USA.
  17. Division of Pulmonary & Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.
  18. Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center and Cincinnati Children's Research Foundation, and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
  19. Division of Lung Diseases, National Heart, Lung, and Blood Institute, Bethesda, MD, USA. Electronic address: [email protected].
  20. Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, and Department of Anesthesia, University of California San Francisco, San Francisco, CA, USA.

PMID: 34310901 PMCID: PMC8302189 DOI: 10.1016/S2213-2600(21)00157-0

Abstract

Acute respiratory distress syndrome (ARDS) is a heterogeneous clinical syndrome. Understanding of the complex pathways involved in lung injury pathogenesis, resolution, and repair has grown considerably in recent decades. Nevertheless, to date, only therapies targeting ventilation-induced lung injury have consistently proven beneficial, and despite these gains, ARDS morbidity and mortality remain high. Many candidate therapies with promise in preclinical studies have been ineffective in human trials, probably at least in part due to clinical and biological heterogeneity that modifies treatment responsiveness in human ARDS. A precision medicine approach to ARDS seeks to better account for this heterogeneity by matching therapies to subgroups of patients that are anticipated to be most likely to benefit, which initially might be identified in part by assessing for heterogeneity of treatment effect in clinical trials. In October 2019, the US National Heart, Lung, and Blood Institute convened a workshop of multidisciplinary experts to explore research opportunities and challenges for accelerating precision medicine in ARDS. Topics of discussion included the rationale and challenges for a precision medicine approach in ARDS, the roles of preclinical ARDS models in precision medicine, essential features of cohort studies to advance precision medicine, and novel approaches to clinical trials to support development and validation of a precision medicine strategy. In this Position Paper, we summarise workshop discussions, recommendations, and unresolved questions for advancing precision medicine in ARDS. Although the workshop took place before the COVID-19 pandemic began, the pandemic has highlighted the urgent need for precision therapies for ARDS as the global scientific community grapples with many of the key concepts, innovations, and challenges discussed at this workshop.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Conflict of interest statement

Declaration of interests JRB reports grants from the US National Institutes of Health (NIH) and Quantum Leap Healthcare Collaborative and personal fees from Sedana Medical and Hamilton Medical, outsid

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