Advancing Precision Medicine for the Diagnosis and Treatment of Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome (ARDS) is a common and life-threatening cause of respiratory failure. Despite decades of research, there are no effective pharmacologic therapies to treat this disease process and mortality remains high. The shortcomings of prior translational research efforts have been increasingly attributed to the heterogeneity of this complex syndrome, which has led to an increased focus on elucidating the mechanisms underlying the interpersonal heterogeneity of ARDS. This shift in focus aims to move the field towards personalized medicine by defining subgroups of ARDS patients with distinct biology, termed endotypes, to quickly identify patients that are most likely to benefit from mechanism targeted treatments. In this review, we first provide a historical perspective and review the key clinical trials that have advanced ARDS treatment. We then review the key challenges that exist with regards to the identification of treatable traits and the implementation of personalized medicine approaches in ARDS. Lastly, we discuss potential strategies and recommendations for future research that we believe will aid in both understanding the molecular pathogenesis of ARDS and the development of personalized treatment approaches.

Automated summary

Acute respiratory distress syndrome (ARDS) is a common and life-threatening cause of respiratory failure, and there are no effective pharmacologic therapies to treat this disease. The shift in focus towards understanding the mechanisms underlying the heterogeneity of ARDS aims to move towards personalized medicine and identify patients who will benefit the most from targeted treatments. This review discusses the historical perspective, clinical trials, challenges, and potential strategies for future research in ARDS.