Novel biomarkers for acute respiratory distress syndrome: genetics, epigenetics and transcriptomics

Acute respiratory distress syndrome (ARDS) can be induced by multiple clinical factors, including sepsis, acute pancreatitis, trauma, intestinal ischemia/reperfusion and burns. However, these factors alone may poorly explain the risk and outcomes of ARDS. Emerging evidence suggests that genomic-based or transcriptomic-based biomarkers may hold the promise to establish predictive or prognostic stratification methods for ARDS, and also to help in developing novel therapeutic targets for ARDS. Notably, genetic/epigenetic variations correlated with susceptibility and prognosis of ARDS and circulating microRNAs have emerged as potential biomarkers for diagnosis or prognosis of ARDS. Although limited by sample size, ethnicity and phenotypic heterogeneity, ongoing genetic/transcriptomic research contributes to the characterization of novel biomarkers and ultimately helps to develop innovative therapeutics for ARDS patients. Lay abstract As the severe form of lung injury, acute respiratory distress syndrome (ARDS) affects about 10% of patients in intensive care units and causes 30-40% of deaths. ARDS can be induced by multiple clinical factors, including sepsis, severe pancreatitis, trauma, intestinal ischemia/reperfusion and burns. Early identification of those with high risk of ARDS would increase diagnostic efficiency and further improve outcomes of patients. Here, we review the most recent evidence that supports the roles of various biomarkers in predicting ARDS risk and outcome. Ongoing research contributes to the characterization of novel biomarkers and ultimately helps to develop innovative and more tailored therapeutics for ARDS patients.