Ji Xiangming, Ji Hong-Long
Department of Nutrition, Georgia State University, Atlanta, Georgia, United States.
Burn and Shock Trauma Research Institute, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, Illinois, United States.
Am J Physiol Lung Cell Mol Physiol. 2024 May 1;326(5):L596-L603. doi: 10.1152/ajplung.00266.2023. Epub 2024 Mar 12.
Acute respiratory distress syndrome (ARDS) is a fatal pulmonary disorder characterized by severe hypoxia and inflammation. ARDS is commonly triggered by systemic and pulmonary infections, with bacteria and viruses. Notable pathogens include , , , coronaviruses, influenza viruses, and herpesviruses. COVID-19 ARDS represents the latest etiological phenotype of the disease. The pathogenesis of ARDS caused by bacteria and viruses exhibits variations in host immune responses and lung mesenchymal injury. We postulate that the systemic and pulmonary metabolomics profiles of ARDS induced by COVID-19 pathogens may exhibit distinctions compared with those induced by other infectious agents. This review aims to compare metabolic signatures in blood and lung specimens specifically within the context of ARDS. Both prevalent and phenotype-specific metabolomic signatures, including but not limited to glycolysis, ketone body production, lipid oxidation, and dysregulation of the kynurenine pathways, were thoroughly examined in this review. The distinctions in metabolic signatures between COVID-19 and non-COVID ARDS have the potential to reveal new biomarkers, elucidate pathogenic mechanisms, identify druggable targets, and facilitate differential diagnosis in the future.
急性呼吸窘迫综合征（ARDS）是一种以严重缺氧和炎症为特征的致命性肺部疾病。ARDS通常由全身性和肺部感染引发，涉及细菌和病毒。值得注意的病原体包括 、 、 、冠状病毒、流感病毒和疱疹病毒。新型冠状病毒肺炎相关的ARDS代表了该疾病最新的病因学表型。由细菌和病毒引起的ARDS的发病机制在宿主免疫反应和肺间充质损伤方面存在差异。我们推测，与其他感染因子诱导的ARDS相比，新型冠状病毒肺炎病原体诱导的ARDS的全身和肺部代谢组学特征可能存在差异。本综述旨在特别在ARDS的背景下比较血液和肺标本中的代谢特征。本综述全面研究了常见的和表型特异性的代谢特征，包括但不限于糖酵解、酮体生成、脂质氧化以及犬尿氨酸途径的失调。新型冠状病毒肺炎相关的ARDS和非新型冠状病毒肺炎相关的ARDS在代谢特征上的差异有可能揭示新的生物标志物、阐明致病机制、确定可成药靶点并在未来促进鉴别诊断。
