Biological basis of critical illness subclasses: from the bedside to the bench and back again.

Autor: Stevens J; Division of Immunobiology, Graduate Program, College of Medicine, University of Cincinnati, Cincinnati, OH, 45267, USA., Tezel O; Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA., Bonnefil V; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45627, USA., Hapstack M; Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA., Atreya MR; Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 45229, USA. Mihir.Atreya@cchmc.org.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45627, USA. Mihir.Atreya@cchmc.org.
Jazyk: angličtina
Zdroj: Critical care (London, England) [Crit Care] 2024 May 29; Vol. 28 (1), pp. 186. Date of Electronic Publication: 2024 May 29.
DOI: 10.1186/s13054-024-04959-3
Abstrakt: Critical illness syndromes including sepsis, acute respiratory distress syndrome, and acute kidney injury (AKI) are associated with high in-hospital mortality and long-term adverse health outcomes among survivors. Despite advancements in care, clinical and biological heterogeneity among patients continues to hamper identification of efficacious therapies. Precision medicine offers hope by identifying patient subclasses based on clinical, laboratory, biomarker and 'omic' data and potentially facilitating better alignment of interventions. Within the previous two decades, numerous studies have made strides in identifying gene-expression based endotypes and clinico-biomarker based phenotypes among critically ill patients associated with differential outcomes and responses to treatment. In this state-of-the-art review, we summarize the biological similarities and differences across the various subclassification schemes among critically ill patients. In addition, we highlight current translational gaps, the need for advanced scientific tools, human-relevant disease models, to gain a comprehensive understanding of the molecular mechanisms underlying critical illness subclasses.
(© 2024. The Author(s).)
Databáze: MEDLINE
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