Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies

Abstract In recent years, the incidence of acute respiratory distress syndrome (ARDS) has been gradually increasing. Despite advances in supportive care, ARDS remains a significant cause of morbidity and mortality in critically ill patients. ARDS is characterized by acute hypoxaemic respiratory fail...

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Main Authors: Wen Ma, Songling Tang, Peng Yao, Tingyuan Zhou, Qingsheng Niu, Peng Liu, Shiyuan Tang, Yao Chen, Lu Gan, Yu Cao
Format: Article
Language:English
Published: Nature Publishing Group 2025-03-01
Series:Signal Transduction and Targeted Therapy
Online Access:https://doi.org/10.1038/s41392-025-02127-9
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author Wen Ma
Songling Tang
Peng Yao
Tingyuan Zhou
Qingsheng Niu
Peng Liu
Shiyuan Tang
Yao Chen
Lu Gan
Yu Cao
author_facet Wen Ma
Songling Tang
Peng Yao
Tingyuan Zhou
Qingsheng Niu
Peng Liu
Shiyuan Tang
Yao Chen
Lu Gan
Yu Cao
author_sort Wen Ma
collection DOAJ
description Abstract In recent years, the incidence of acute respiratory distress syndrome (ARDS) has been gradually increasing. Despite advances in supportive care, ARDS remains a significant cause of morbidity and mortality in critically ill patients. ARDS is characterized by acute hypoxaemic respiratory failure with diffuse pulmonary inflammation and bilateral edema due to excessive alveolocapillary permeability in patients with non-cardiogenic pulmonary diseases. Over the past seven decades, our understanding of the pathology and clinical characteristics of ARDS has evolved significantly, yet it remains an area of active research and discovery. ARDS is highly heterogeneous, including diverse pathological causes, clinical presentations, and treatment responses, presenting a significant challenge for clinicians and researchers. In this review, we comprehensively discuss the latest advancements in ARDS research, focusing on its heterogeneity, pathophysiological mechanisms, and emerging therapeutic approaches, such as cellular therapy, immunotherapy, and targeted therapy. Moreover, we also examine the pathological characteristics of COVID-19-related ARDS and discuss the corresponding therapeutic approaches. In the face of challenges posed by ARDS heterogeneity, recent advancements offer hope for improved patient outcomes. Further research is essential to translate these findings into effective clinical interventions and personalized treatment approaches for ARDS, ultimately leading to better outcomes for patients suffering from ARDS.
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spelling doaj-art-6ec9fda8f48e4d239b86632ac396abb52025-08-20T02:59:57ZengNature Publishing GroupSignal Transduction and Targeted Therapy2059-36352025-03-0110113510.1038/s41392-025-02127-9Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategiesWen Ma0Songling Tang1Peng Yao2Tingyuan Zhou3Qingsheng Niu4Peng Liu5Shiyuan Tang6Yao Chen7Lu Gan8Yu Cao9Department of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityDepartment of Emergency Medicine, Institute of Disaster Medicine and Institute of Emergency Medicine, West China Hospital, Sichuan UniversityAbstract In recent years, the incidence of acute respiratory distress syndrome (ARDS) has been gradually increasing. Despite advances in supportive care, ARDS remains a significant cause of morbidity and mortality in critically ill patients. ARDS is characterized by acute hypoxaemic respiratory failure with diffuse pulmonary inflammation and bilateral edema due to excessive alveolocapillary permeability in patients with non-cardiogenic pulmonary diseases. Over the past seven decades, our understanding of the pathology and clinical characteristics of ARDS has evolved significantly, yet it remains an area of active research and discovery. ARDS is highly heterogeneous, including diverse pathological causes, clinical presentations, and treatment responses, presenting a significant challenge for clinicians and researchers. In this review, we comprehensively discuss the latest advancements in ARDS research, focusing on its heterogeneity, pathophysiological mechanisms, and emerging therapeutic approaches, such as cellular therapy, immunotherapy, and targeted therapy. Moreover, we also examine the pathological characteristics of COVID-19-related ARDS and discuss the corresponding therapeutic approaches. In the face of challenges posed by ARDS heterogeneity, recent advancements offer hope for improved patient outcomes. Further research is essential to translate these findings into effective clinical interventions and personalized treatment approaches for ARDS, ultimately leading to better outcomes for patients suffering from ARDS.https://doi.org/10.1038/s41392-025-02127-9
spellingShingle Wen Ma
Songling Tang
Peng Yao
Tingyuan Zhou
Qingsheng Niu
Peng Liu
Shiyuan Tang
Yao Chen
Lu Gan
Yu Cao
Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies
Signal Transduction and Targeted Therapy
title Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies
title_full Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies
title_fullStr Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies
title_full_unstemmed Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies
title_short Advances in acute respiratory distress syndrome: focusing on heterogeneity, pathophysiology, and therapeutic strategies
title_sort advances in acute respiratory distress syndrome focusing on heterogeneity pathophysiology and therapeutic strategies
url https://doi.org/10.1038/s41392-025-02127-9
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