Vera Luiza Capelozzi, Timothy Craig Allen, Mary Beth Beasley, Philip T. Cagle, Don Guinee, Lida P. Hariri, Aliya N. Husain, Deepali Jain, Sylvie Lantuejoul, Brandon T. Larsen, Ross Miller, Mari Mino-Kenudson, Mehrad Mitra, Kirtee Raparia, Anja Roden, Frank Schneider, Lynette M. Sholl, and Maxwell Lawrence Smith (2017) Molecular and Immune Biomarkers in Acute Respiratory Distress Syndrome: A Perspective From Members of the Pulmonary Pathology Society. Archives of Pathology & Laboratory Medicine In-Press.
Early Online Release
Vera Luiza Capelozzi, MD, PhD; Timothy Craig Allen, MD, JD; Mary Beth Beasley, MD; Philip T. Cagle, MD; Don Guinee, MD; Lida P. Hariri, MD, PhD; Aliya N. Husain, MD; Deepali Jain, MD, DNB, FIAC; Sylvie Lantuejoul, MD, PhD; Brandon T. Larsen, MD, PhD; Ross Miller, MD; Mari Mino-Kenudson, MD; Mehrad Mitra, MD; Kirtee Raparia, MD; Anja Roden, MD; Frank Schneider, MD; Lynette M. Sholl, MD; Maxwell Lawrence Smith, MD
Acute respiratory distress syndrome (ARDS) is a multifactorial syndrome with high morbidity and mortality rates, characterized by deficiency in gas exchange and lung mechanics that lead to hypoxemia, dyspnea, and respiratory failure. Histologically, ARDS is characterized by an acute, exudative phase, combining diffuse alveolar damage and noncardiogenic edema, followed by a later fibroproliferative phase. Despite an enhanced understanding of ARDS pathogenesis, the capacity to predict the development of ARDS and to risk-stratify patients with the disease remains limited. Biomarkers may help to identify patients at the greatest risk of developing ARDS, to evaluate response to therapy, to predict outcome, and to improve clinical trials. The ARDS pathogenesis is presented in this article, as well as concepts and information on biomarkers that are currently used clinically or are available for laboratory use by academic and practicing pathologists and the developing and validating of new assays, focusing on the assays' major biologic roles in lung injury and/or repair and to ultimately suggest innovative, therapeutic approaches.