Personalized medicine targeting different ARDS phenotypes: The future of pharmacotherapy for ARDS?

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM Expert Review of Respiratory Medicine Pub Date : 2023-01-01 DOI:10.1080/17476348.2023.2176302
Florian Blanchard, Arthur James, Mona Assefi, Natacha Kapandji, Jean-Michel Constantin
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引用次数: 1

Abstract

Introduction: Acute respiratory distress syndrome (ARDS) still represents a major challenge with high mortality rates and altered quality of life. Many well-designed studies have failed to improve ARDS outcomes. Heterogeneity of etiologies, mechanisms of lung damage, different lung mechanics, and different treatment approaches may explain these failures. At the era of personalized medicine, ARDS phenotyping is not only a field of research, but a bedside consideration when implementing therapy. ARDS has moved from being a simple syndrome to a more complex area of subgrouping. Intensivists must understand these phenotypes and therapies associated with a better outcome.

Areas covered: After a brief sum-up of the different type of ARDS phenotypes, we will present some relevant therapy that may be impacted by phenotyping. A focus on pharmacotherapy will be realized before a section on non-pharmaceutical strategies. Eventually, we will highlight the limits of our knowledge of phenotyping and the pitfalls of personalized medicine.

Expert opinion: Biological and morphological ARDS phenotypes are now well studied. The future of ARDS therapy will go through phenotyping that allows a personalized medication for each patient. However, a better assessment of these phenotypes is required, and clinical trials should be conducted with an ad-hoc phenotyping before randomization.

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针对不同ARDS表型的个性化药物治疗:ARDS药物治疗的未来?
简介:急性呼吸窘迫综合征(ARDS)仍然是一个具有高死亡率和生活质量改变的主要挑战。许多精心设计的研究未能改善ARDS的结果。病因的异质性、肺损伤机制、不同的肺力学和不同的治疗方法可能解释这些失败。在个性化医疗时代,ARDS表型不仅是一个研究领域,而且是实施治疗时的床边考虑因素。ARDS已经从一个简单的综合征转变为一个更复杂的亚组领域。强化医生必须了解这些表型和治疗与更好的结果相关。涵盖领域:在简要总结了不同类型的ARDS表型后,我们将介绍一些可能受表型影响的相关治疗。在非药物策略部分之前,将重点介绍药物治疗。最后,我们将强调我们对表型的知识的局限性和个性化医疗的陷阱。专家意见:目前对ARDS的生物学和形态学表型进行了很好的研究。未来的ARDS治疗将通过表型分析,为每个患者提供个性化的药物治疗。然而,需要对这些表型进行更好的评估,并且在随机化之前应该使用特设表型进行临床试验。
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来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
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