scholarly journals Gene Therapy for Acute Respiratory Distress Syndrome

2022 ◽  
Vol 12 ◽  
Author(s):  
Jing Liu ◽  
David A. Dean
Keyword(s):  
Gene Therapy ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Single Gene ◽  
Treatment Strategies ◽  
The United States ◽  
Clinical Syndrome ◽  
Underlying Mechanisms

Acute respiratory distress syndrome (ARDS) is a devastating clinical syndrome that leads to acute respiratory failure and accounts for over 70,000 deaths per year in the United States alone, even prior to the COVID-19 pandemic. While its molecular details have been teased apart and its pathophysiology largely established over the past 30 years, relatively few pharmacological advances in treatment have been made based on this knowledge. Indeed, mortality remains very close to what it was 30 years ago. As an alternative to traditional pharmacological approaches, gene therapy offers a highly controlled and targeted strategy to treat the disease at the molecular level. Although there is no single gene or combination of genes responsible for ARDS, there are a number of genes that can be targeted for upregulation or downregulation that could alleviate many of the symptoms and address the underlying mechanisms of this syndrome. This review will focus on the pathophysiology of ARDS and how gene therapy has been used for prevention and treatment. Strategies for gene delivery to the lung, such as barriers encountered during gene transfer, specific classes of genes that have been targeted, and the outcomes of these approaches on ARDS pathogenesis and resolution will be discussed.

Acute Respiratory Distress Syndrome: Etiology, Pathogenesis, and Summary on Management

2019 ◽  
Vol 35 (8) ◽  
pp. 723-737 ◽  
Author(s):  
Shawn Kaku ◽  
Christopher D. Nguyen ◽  
Natalie N. Htet ◽  
Dominic Tutera ◽  
Juliana Barr ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Acute Lung Inflammation ◽  
Hypoxemic Respiratory Failure ◽  
Pulmonary Vascular Permeability ◽  
Current State

The acute respiratory distress syndrome (ARDS) has multiple causes and is characterized by acute lung inflammation and increased pulmonary vascular permeability, leading to hypoxemic respiratory failure and bilateral pulmonary radiographic opacities. The acute respiratory distress syndrome is associated with substantial morbidity and mortality, and effective treatment strategies are limited. This review presents the current state of the literature regarding the etiology, pathogenesis, and management strategies for ARDS.

scholarly journals Trends in Extracorporeal Membrane Oxygenation for the Treatment of Acute Respiratory Distress Syndrome in the United States

2016 ◽  
Vol 32 (9) ◽  
pp. 535-539 ◽  
Author(s):  
Barret Rush ◽  
Katie Wiskar ◽  
Landon Berger ◽  
Donald Griesdale
Keyword(s):  
United States ◽  
Acute Respiratory Distress Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
International Classification Of Diseases ◽  
The United States ◽  
Relative Increase ◽  
Membrane Oxygenation

Objectives: Our aim was to describe patient characteristics and trends in the use of extracorporeal membrane oxygenation (ECMO) for the treatment of acute respiratory distress syndrome (ARDS) in the United States from 2006 to 2011. Methods: We used the Nationwide Inpatient Sample to isolate all patients aged 18 years who had a discharge International Classification of Diseases, Ninth Revision diagnosis of ARDS, with and without procedure codes for ECMO, between 2006 and 2011. Results: We examined a total of 47 911 414 hospital discharges, representing 235 911 271 hospitalizations using national weights. Of the 1 479 022 patients meeting the definition of ARDS (representing 7 281 206 discharges), 775 underwent ECMO. There was a 409% relative increase in the use of ECMO for ARDS in the United States between 2006 and 2011, from 0.0178% to 0.090% ( P = .0041). Patients treated with ECMO had higher in-hospital mortality (58.6% vs 25.1%, P < .0001) and longer hospital stays (15.8 days vs 6.9 days, P < .0001). They were also younger (47.9 vs 66.4 years, P < .0001) and more likely to be male (62.2% vs 49.6%, P < .0001). The median time to initiate ECMO from the time of admission was 0.5 days (interquartile range [IQR] 4.9 days). Conclusion: There has been a dramatic increase in ECMO use for the treatment of ARDS in the United States.

scholarly journals Acute respiratory distress syndrome in COVID-19: possible mechanisms and therapeutic management

Pneumonia ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Anolin Aslan ◽  
Cynthia Aslan ◽  
Naime Majidi Zolbanin ◽  
Reza Jafari
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Lung Diseases ◽  
Distress Syndrome ◽  
Treatment Strategies ◽  
Current Treatment ◽  
New Era ◽  
Experimental Drugs ◽  
Lung Failure

AbstractCOVID-19 pandemic is a serious concern in the new era. Acute respiratory distress syndrome (ARDS), and lung failure are the main lung diseases in COVID-19 patients. Even though COVID-19 vaccinations are available now, there is still an urgent need to find potential treatments to ease the effects of COVID-19 on already sick patients. Multiple experimental drugs have been approved by the FDA with unknown efficacy and possible adverse effects. Probably the increasing number of studies worldwide examining the potential COVID-19 related therapies will help to identification of effective ARDS treatment. In this review article, we first provide a summary on immunopathology of ARDS next we will give an overview of management of patients with COVID-19 requiring intensive care unit (ICU), while focusing on the current treatment strategies being evaluated in the clinical trials in COVID-19-induced ARDS patients.

scholarly journals Intestinal Collinsella may mitigate infection and exacerbation of COVID-19 by producing ursodeoxycholate

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260451
Author(s):  
Masaaki Hirayama ◽  
Hiroshi Nishiwaki ◽  
Tomonari Hamaguchi ◽  
Mikako Ito ◽  
Jun Ueyama ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Gut Microbiota ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Mortality Rates ◽  
Sequencing Data ◽  
Angiotensin Converting Enzyme 2 ◽  
Underlying Mechanisms ◽  
Apoptotic Effects

The mortality rates of COVID-19 vary widely across countries, but the underlying mechanisms remain unelucidated. We aimed at the elucidation of relationship between gut microbiota and the mortality rates of COVID-19 across countries. Raw sequencing data of 16S rRNA V3-V5 regions of gut microbiota in 953 healthy subjects in ten countries were obtained from the public database. We made a generalized linear model (GLM) to predict the COVID-19 mortality rates using gut microbiota. GLM revealed that low genus Collinsella predicted high COVID-19 mortality rates with a markedly low p-value. Unsupervised clustering of gut microbiota in 953 subjects yielded five enterotypes. The mortality rates were increased from enterotypes 1 to 5, whereas the abundances of Collinsella were decreased from enterotypes 1 to 5 except for enterotype 2. Collinsella produces ursodeoxycholate. Ursodeoxycholate was previously reported to inhibit binding of SARS-CoV-2 to angiotensin-converting enzyme 2; suppress pro-inflammatory cytokines like TNF-α, IL-1β, IL-2, IL-4, and IL-6; have antioxidant and anti-apoptotic effects; and increase alveolar fluid clearance in acute respiratory distress syndrome. Ursodeoxycholate produced by Collinsella may prevent COVID-19 infection and ameliorate acute respiratory distress syndrome in COVID-19 by suppressing cytokine storm syndrome.

A case of vaping-induced acute respiratory distress syndrome requiring extracorporeal life support

Perfusion ◽  
2020 ◽  
pp. 026765912092563
Author(s):  
Sudhir Krishnan ◽  
Guramrinder Singh Thind ◽  
Mona Soliman ◽  
Leslie Tolle ◽  
Eduardo Mireles-Cabodevila ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
The United States ◽  
Product Use

Introduction: An upsurge of e-cigarette, or vaping, product use–associated lung injury has been reported in the United States. The potential role of extracorporeal life support in e-cigarette, or vaping, product use–associated lung injury merits consideration. Case report: We present a case of vaping-induced severe acute respiratory distress syndrome that was salvaged with extracorporeal life support and had excellent recovery. Discussion: The mechanistic reasons for the sudden outbreak of e-cigarette, or vaping, product use–associated lung injury are under active investigation. A predominantly diffuse, bilateral pattern of lung injury has been reported, with some cases meeting the criteria for severe acute respiratory distress syndrome. To date, 68 deaths from e-cigarette, or vaping, product use–associated lung injury have been confirmed by the centers of disease control. However, resolution of lung injury has been reported in most cases, thereby justifying candidacy for extracorporeal life support, if required. Conclusion: Extracorporeal life support can be successfully utilized as a bridge to recovery in vaping-induced severe acute respiratory distress syndrome.

Understanding Gene Therapy in Acute Respiratory Distress Syndrome

2019 ◽  
Vol 19 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Xue-Peng Zhang ◽  
Wei-Tao Zhang ◽  
Yue Qiu ◽  
Min-Jie Ju ◽  
Guo-Wei Tu ◽  
...  
Keyword(s):  
Gene Therapy ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Defense Mechanisms ◽  
Viral Vectors ◽  
Distress Syndrome ◽  
Fluid Management ◽  
Alveolar Epithelial Cells ◽  
Inhaled Particles

Acute Respiratory Distress Syndrome (ARDS) and its complications remain lifethreatening conditions for critically ill patients. The present therapeutic strategies such as prone positioning ventilation strategies, nitric oxide inhalation, restrictive intravenous fluid management, and extracorporeal membrane oxygenation (ECMO) do not contribute much to improving the mortality of ARDS. The advanced understanding of the pathophysiology of acute respiratory distress syndrome suggests that gene-based therapy may be an innovative method for this disease. Many scientists have made beneficial attempts to regulate the immune response genes of ARDS, maintain the normal functions of alveolar epithelial cells and endothelial cells, and inhibit the fibrosis and proliferation of ARDS. Limitations to effective pulmonary gene therapy still exist, including the security of viral vectors and the pulmonary defense mechanisms against inhaled particles. Here, we summarize and review the mechanism of gene therapy for acute respiratory distress syndrome and its application.

Interleukin 8 and Acute Lung Injury

2013 ◽  
Vol 138 (2) ◽  
pp. 266-269 ◽  
Author(s):  
Timothy Craig Allen ◽  
Anna Kurdowska
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Syndrome ◽  
Interleukin 8 ◽  
Microvascular Damage ◽  
Lung Endothelial Cells

Acute lung injury is a complex clinical syndrome involving acute inflammation, microvascular damage, and increased pulmonary vascular and epithelial permeability, frequently resulting in acute respiratory failure culminating in often-fatal acute respiratory distress syndrome. Interleukin 8 (IL-8), a potent neutrophil attractant and activator, plays a significant role in acute lung injury via the formation of anti–IL-8 autoantibody:IL-8 complexes and those complexes' interaction with FcγRIIa receptors, leading to the development of acute lung injury by, among other possible mechanisms, effecting neutrophil apoptosis. These complexes may also interact with lung endothelial cells in patients with acute respiratory distress syndrome. Continuing research of the role of neutrophils, IL-8, anti–IL-8 autoantibody:IL-8 complexes, and FcγRIIa receptors may ultimately provide molecular therapies that could lower acute respiratory distress syndrome mortality, as well as reduce or even prevent the development of acute lung injury altogether.

Acute Respiratory Distress Syndrome

2019 ◽  
pp. 137-141
Author(s):  
Richard K. Patch ◽  
James Y. Findlay
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Syndrome ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Neurocognitive Dysfunction ◽  
Psychiatric Illnesses ◽  
Pulmonary Damage

Acute respiratory distress syndrome (ARDS) is a clinical syndrome characterized by acute hypoxemic respiratory failure. Patients with ARDS have pulmonary damage from an acute, usually severe, diffuse inflammatory lung injury that leads to increased vascular permeability and loss of aerated tissue. Mortality from ARDS is estimated to range from 26% to 58%, and in-hospital mortality is high (46.1%) for those with severe ARDS. Survivors have extensive morbidity, including neurocognitive dysfunction, physical disabilities, and psychiatric illnesses such as depression, anxiety, and posttraumatic stress disorder. Lung function may be compromised for as long as 5 years.

scholarly journals Recent advances in understanding and treating ARDS

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 725 ◽  
Author(s):  
Rebecca M. Baron ◽  
Bruce D. Levy
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Clinical Care ◽  
Treatment Strategies ◽  
Preventive Strategies ◽  
Recent Advances ◽  
Improved Outcomes ◽  
Considerable Morbidity

Acute respiratory distress syndrome represents a complex syndrome with considerable morbidity and mortality, for which there exist no targeted treatment strategies. However, recent advances in clinical care have improved outcomes, and we will review a number of these approaches here, as well as explore the mechanisms underlying the benefit of intervention that might point us in the direction toward future treatment and preventive strategies for this devastating syndrome.

Sign in / Sign up

Export Citation Format

Share Document