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Published in: Intensive Care Medicine 2/2015

01-02-2015 | What's New in Intensive Care

Future therapies for ARDS

Authors: Gerard F. Curley, John G. Laffey

Published in: Intensive Care Medicine | Issue 2/2015

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Excerpt

Despite more than 150 randomized clinical trials (RCTs) of multiple potential therapies, the only interventions for acute respiratory distress syndrome (ARDS) that reduce mortality are those that minimize ventilator-induced lung injury [1]. This ‘translational failure’ may have a number of explanations. Firstly, ARDS is a syndrome, and interventional trials in ARDS generally include a heterogenous patient group with a wide spectrum of disease etiology and disease severity. Second, deficits exist in our understanding of key aspects of the pathogenesis of ARDS. Notwithstanding these challenges, a number of promising therapies are currently under investigation for ARDS, and offer hope for the future. …
Literature
1.
go back to reference Tonelli AR, Zein J, Adams J, Ioannidis JP (2014) Effects of interventions on survival in acute respiratory distress syndrome: an umbrella review of 159 published randomized trials and 29 meta-analyses. Intensive Care Med 40(6):769–787PubMedCrossRef Tonelli AR, Zein J, Adams J, Ioannidis JP (2014) Effects of interventions on survival in acute respiratory distress syndrome: an umbrella review of 159 published randomized trials and 29 meta-analyses. Intensive Care Med 40(6):769–787PubMedCrossRef
2.
go back to reference Erlich JM, Talmor DS, Cartin-Ceba R, Gajic O, Kor DJ (2011) Prehospitalization antiplatelet therapy is associated with a reduced incidence of acute lung injury: a population-based cohort study. Chest 139:289–295PubMedCentralPubMedCrossRef Erlich JM, Talmor DS, Cartin-Ceba R, Gajic O, Kor DJ (2011) Prehospitalization antiplatelet therapy is associated with a reduced incidence of acute lung injury: a population-based cohort study. Chest 139:289–295PubMedCentralPubMedCrossRef
3.
go back to reference Kor DJ, Talmor DS, Banner-Goodspeed VM, Carter RE, Hinds R, Park PK, Gajic O, Gong MN, US Critical Illness and Injury Trials Group: Lung Injury Prevention with Aspirin Study Group (USCIITG: LIPS-A) (2012) Lung injury prevention with aspirin (LIPS-A): a protocol for a multicentre randomised clinical trial in medical patients at high risk of acute lung injury. BMJ Open:2(5) Kor DJ, Talmor DS, Banner-Goodspeed VM, Carter RE, Hinds R, Park PK, Gajic O, Gong MN, US Critical Illness and Injury Trials Group: Lung Injury Prevention with Aspirin Study Group (USCIITG: LIPS-A) (2012) Lung injury prevention with aspirin (LIPS-A): a protocol for a multicentre randomised clinical trial in medical patients at high risk of acute lung injury. BMJ Open:2(5)
4.
go back to reference Craig TR, Duffy MJ, Shyamsundar M, McDowell C, O’Kane CM, Elborn JS, McAuley DF (2011) A randomized clinical trial of hydroxymethylglutaryl-coenzyme a reductase inhibition for acute lung injury (The HARP Study). Am J Respir Crit Care Med 183:620–626PubMedCrossRef Craig TR, Duffy MJ, Shyamsundar M, McDowell C, O’Kane CM, Elborn JS, McAuley DF (2011) A randomized clinical trial of hydroxymethylglutaryl-coenzyme a reductase inhibition for acute lung injury (The HARP Study). Am J Respir Crit Care Med 183:620–626PubMedCrossRef
5.
go back to reference McAuley DF, Laffey JG, O’Kane CM, Perkins GD, Mullan B, Trinder TJ, Johnston P, Hopkins PA, Johnston AJ, McDowell C, McNally C, HARP-2 Investigators, Irish Critical Care Trials Group (2014) Simvastatin in the acute respiratory distress syndrome. N Engl J Med 371:1695–1703PubMedCrossRef McAuley DF, Laffey JG, O’Kane CM, Perkins GD, Mullan B, Trinder TJ, Johnston P, Hopkins PA, Johnston AJ, McDowell C, McNally C, HARP-2 Investigators, Irish Critical Care Trials Group (2014) Simvastatin in the acute respiratory distress syndrome. N Engl J Med 371:1695–1703PubMedCrossRef
6.
go back to reference National Heart L, Blood Institute ACTN, Truwit JD, Bernard GR, Steingrub J, Matthay MA, Liu KD, Albertson TE, Brower RG, Shanholtz C, Rock P, Douglas IS, de Boisblanc BP, Hough CL, Hite RD, Thompson BT (2014) Rosuvastatin for sepsis-associated acute respiratory distress syndrome. N Engl J Med 370:2191–2200PubMedCrossRef National Heart L, Blood Institute ACTN, Truwit JD, Bernard GR, Steingrub J, Matthay MA, Liu KD, Albertson TE, Brower RG, Shanholtz C, Rock P, Douglas IS, de Boisblanc BP, Hough CL, Hite RD, Thompson BT (2014) Rosuvastatin for sepsis-associated acute respiratory distress syndrome. N Engl J Med 370:2191–2200PubMedCrossRef
7.
go back to reference Dixon B, Schultz MJ, Smith R, Fink JB, Santamaria JD, Campbell DJ (2010) Nebulized heparin is associated with fewer days of mechanical ventilation in critically ill patients: a randomized controlled trial. Crit Care 14:R180PubMedCentralPubMedCrossRef Dixon B, Schultz MJ, Smith R, Fink JB, Santamaria JD, Campbell DJ (2010) Nebulized heparin is associated with fewer days of mechanical ventilation in critically ill patients: a randomized controlled trial. Crit Care 14:R180PubMedCentralPubMedCrossRef
8.
go back to reference Bellingan G, Maksimow M, Howell DC, Stotz M, Beale R, Beatty M, Walsh T, Binning A, Davidson A, Kuper M, Shah S, Cooper J, Waris M, Yegutkin GG, Jalkanen J, Salmi M, Piippo I, Jalkanen M, Montgomery H, Jalkanen S (2014) The effect of intravenous interferon-beta-1a (FP-1201) on lung CD73 expression and on acute respiratory distress syndrome mortality: an open-label study. Lancet Respir Med 2:98–107PubMedCrossRef Bellingan G, Maksimow M, Howell DC, Stotz M, Beale R, Beatty M, Walsh T, Binning A, Davidson A, Kuper M, Shah S, Cooper J, Waris M, Yegutkin GG, Jalkanen J, Salmi M, Piippo I, Jalkanen M, Montgomery H, Jalkanen S (2014) The effect of intravenous interferon-beta-1a (FP-1201) on lung CD73 expression and on acute respiratory distress syndrome mortality: an open-label study. Lancet Respir Med 2:98–107PubMedCrossRef
9.
go back to reference Bertok S, Wilson MR, Morley PJ, de Wildt R, Bayliffe A, Takata M (2012) Selective inhibition of intra-alveolar p55 TNF receptor attenuates ventilator-induced lung injury. Thorax 67:244–251PubMedCentralPubMedCrossRef Bertok S, Wilson MR, Morley PJ, de Wildt R, Bayliffe A, Takata M (2012) Selective inhibition of intra-alveolar p55 TNF receptor attenuates ventilator-induced lung injury. Thorax 67:244–251PubMedCentralPubMedCrossRef
10.
go back to reference Proudfoot AG, O’Kane CM, Bayliffe A, Serone AP, Bareille P, Smith SP, Brown V, Wright TJ, Chen Y, Wilson R, Cordy JC, Morley PJ, Elborn S, Hind M, Chilvers ER, Griffiths MJ, Summers C, McAuley DF (2014) A novel TNFR1-targeting domain antibody attenuates pulmonary inflammation in a human model of lung injury, via actions on the lung micro-vascular endothelium. Am J Respir Crit Care Med 189:A6589 Proudfoot AG, O’Kane CM, Bayliffe A, Serone AP, Bareille P, Smith SP, Brown V, Wright TJ, Chen Y, Wilson R, Cordy JC, Morley PJ, Elborn S, Hind M, Chilvers ER, Griffiths MJ, Summers C, McAuley DF (2014) A novel TNFR1-targeting domain antibody attenuates pulmonary inflammation in a human model of lung injury, via actions on the lung micro-vascular endothelium. Am J Respir Crit Care Med 189:A6589
11.
go back to reference Imai Y, Kuba K, Rao S, Huan Y, Guo F, Guan B, Yang P, Sarao R, Wada T, Leong-Poi H, Crackower MA, Fukamizu A, Hui CC, Hein L, Uhlig S, Slutsky AS, Jiang C, Penninger JM (2005) Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature 436:112–116PubMedCrossRef Imai Y, Kuba K, Rao S, Huan Y, Guo F, Guan B, Yang P, Sarao R, Wada T, Leong-Poi H, Crackower MA, Fukamizu A, Hui CC, Hein L, Uhlig S, Slutsky AS, Jiang C, Penninger JM (2005) Angiotensin-converting enzyme 2 protects from severe acute lung failure. Nature 436:112–116PubMedCrossRef
12.
go back to reference Kuba K, Imai Y, Rao S, Gao H, Guo F, Guan B, Huan Y, Yang P, Zhang Y, Deng W, Bao L, Zhang B, Liu G, Wang Z, Chappell M, Liu Y, Zheng D, Leibbrandt A, Wada T, Slutsky AS, Liu D, Qin C, Jiang C, Penninger JM (2005) A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med 11:875–879PubMedCrossRef Kuba K, Imai Y, Rao S, Gao H, Guo F, Guan B, Huan Y, Yang P, Zhang Y, Deng W, Bao L, Zhang B, Liu G, Wang Z, Chappell M, Liu Y, Zheng D, Leibbrandt A, Wada T, Slutsky AS, Liu D, Qin C, Jiang C, Penninger JM (2005) A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med 11:875–879PubMedCrossRef
13.
go back to reference Adamzik M, Frey U, Sixt S, Knemeyer L, Beiderlinden M, Peters J, Siffert W (2007) ACE I/D but not AGT (-6)A/G polymorphism is a risk factor for mortality in ARDS. Eur Respir J 29:482–488PubMedCrossRef Adamzik M, Frey U, Sixt S, Knemeyer L, Beiderlinden M, Peters J, Siffert W (2007) ACE I/D but not AGT (-6)A/G polymorphism is a risk factor for mortality in ARDS. Eur Respir J 29:482–488PubMedCrossRef
14.
go back to reference Temmesfeld-Wollbruck B, Hocke AC, Suttorp N, Hippenstiel S (2007) Adrenomedullin and endothelial barrier function. Thromb Haemost 98:944–951PubMed Temmesfeld-Wollbruck B, Hocke AC, Suttorp N, Hippenstiel S (2007) Adrenomedullin and endothelial barrier function. Thromb Haemost 98:944–951PubMed
15.
go back to reference Shyamsundar M, McAuley DF, Ingram RJ, Gibson DS, O’Kane D, McKeown ST, Edwards A, Taggart C, Elborn JS, Calfee CS, Matthay MA, O’Kane CM (2014) Keratinocyte growth factor promotes epithelial survival and resolution in a human model of lung injury. Am J Respir Crit Care Med 189:1520–1529PubMedCentralPubMedCrossRef Shyamsundar M, McAuley DF, Ingram RJ, Gibson DS, O’Kane D, McKeown ST, Edwards A, Taggart C, Elborn JS, Calfee CS, Matthay MA, O’Kane CM (2014) Keratinocyte growth factor promotes epithelial survival and resolution in a human model of lung injury. Am J Respir Crit Care Med 189:1520–1529PubMedCentralPubMedCrossRef
16.
go back to reference Curley GF, Scott JA, Laffey JG (2014) Therapeutic potential and mechanisms of action of mesenchymal stromal cells for acute respiratory distress syndrome. Curr Stem Cell Res Ther 9:319–329PubMedCrossRef Curley GF, Scott JA, Laffey JG (2014) Therapeutic potential and mechanisms of action of mesenchymal stromal cells for acute respiratory distress syndrome. Curr Stem Cell Res Ther 9:319–329PubMedCrossRef
17.
go back to reference Curley GF, Ansari B, Hayes M, Devaney J, Masterson C, Ryan A, Barry F, O’Brien T, Toole DO, Laffey JG (2013) Effects of intratracheal mesenchymal stromal cell therapy during recovery and resolution after ventilator-induced lung injury. Anesthesiology 118:924–932PubMedCrossRef Curley GF, Ansari B, Hayes M, Devaney J, Masterson C, Ryan A, Barry F, O’Brien T, Toole DO, Laffey JG (2013) Effects of intratracheal mesenchymal stromal cell therapy during recovery and resolution after ventilator-induced lung injury. Anesthesiology 118:924–932PubMedCrossRef
18.
go back to reference Curley GF, Hayes M, Ansari B, Shaw G, Ryan A, Barry F, O’Brien T, O’Toole D, Laffey JG (2012) Mesenchymal stem cells enhance recovery and repair following ventilator-induced lung injury in the rat. Thorax 67:496–501PubMedCrossRef Curley GF, Hayes M, Ansari B, Shaw G, Ryan A, Barry F, O’Brien T, O’Toole D, Laffey JG (2012) Mesenchymal stem cells enhance recovery and repair following ventilator-induced lung injury in the rat. Thorax 67:496–501PubMedCrossRef
19.
go back to reference Zheng G, Huang L, Tong H, Shu Q, Hu Y, Ge M, Deng K, Zhang L, Zou B, Cheng B, Xu J (2014) Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study. Respir Res 15:39PubMedCentralPubMedCrossRef Zheng G, Huang L, Tong H, Shu Q, Hu Y, Ge M, Deng K, Zhang L, Zou B, Cheng B, Xu J (2014) Treatment of acute respiratory distress syndrome with allogeneic adipose-derived mesenchymal stem cells: a randomized, placebo-controlled pilot study. Respir Res 15:39PubMedCentralPubMedCrossRef
Metadata
Title
Future therapies for ARDS
Authors
Gerard F. Curley
John G. Laffey
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 2/2015
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-014-3578-z

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