Acute respiratory distress syndrome (ARDS) is a life-threatening critical care syndrome commonly associated with infections such as COVID-19, influenza, and bacterial pneumonia. Ongoing research aims to improve our understanding of ARDS, including its molecular mechanisms, individualized treatment options, and potential interventions to reduce inflammation and promote lung repair. To map and compare metabolic phenotypes of different infectious causes of ARDS to better understand the metabolic pathways involved in the underlying pathogenesis. We analyzed metabolic phenotypes of 3 ARDS cohorts caused by COVID-19, H1N1 influenza, and bacterial pneumonia compared to non-ARDS COVID-19-infected patients and ICU-ventilated controls. Targeted metabolomics was performed on plasma samples from a total of 150 patients using quantitative LC–MS/MS and DI-MS/MS analytical platforms. Distinct metabolic phenotypes were detected between different infectious causes of ARDS. There were metabolomics differences between ARDSs associated with COVID-19 and H1N1, which include metabolic pathways involving taurine and hypotaurine, pyruvate, TCA cycle metabolites, lysine, and glycerophospholipids. ARDSs associated with bacterial pneumonia and COVID-19 differed in the metabolism of D-glutamine and D-glutamate, arginine, proline, histidine, and pyruvate. The metabolic profile of COVID-19 ARDS (C19/A) patients admitted to the ICU differed from COVID-19 pneumonia (C19/P) patients who were not admitted to the ICU in metabolisms of phenylalanine, tryptophan, lysine, and tyrosine. Metabolomics analysis revealed significant differences between C19/A, H1N1/A, and PNA/A vs ICU-ventilated controls, reflecting potentially different disease mechanisms. Different metabolic phenotypes characterize ARDS associated with different viral and bacterial infections.

中文翻译：

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使用靶向代谢组学方法探索与 COVID-19 相关的 ARDS 与 H1N1 流感和细菌性肺炎引起的 ARDS 的差异

急性呼吸窘迫综合征 (ARDS) 是一种危及生命的重症监护综合征，通常与 COVID-19、流感和细菌性肺炎等感染相关。正在进行的研究旨在提高我们对 ARDS 的了解，包括其分子机制、个体化治疗方案以及减少炎症和促进肺部修复的潜在干预措施。绘制和比较 ARDS 不同感染原因的代谢表型，以更好地了解参与潜在发病机制的代谢途径。我们分析了由 COVID-19、H1N1 流感和细菌性肺炎引起的 3 个 ARDS 队列的代谢表型，与非 ARDS COVID-19 感染患者和 ICU 通气对照患者进行比较。使用定量 LC-MS/MS 和 DI-MS/MS 分析平台对总共 150 名患者的血浆样本进行了靶向代谢组学分析。在 ARDS 的不同感染原因之间检测到不同的代谢表型。与 COVID-19 和 H1N1 相关的 ARDS 之间存在代谢组学差异，其中包括涉及牛磺酸和亚牛磺酸、丙酮酸、TCA 循环代谢物、赖氨酸和甘油磷脂的代谢途径。与细菌性肺炎和 COVID-19 相关的 ARDS 在 D-谷氨酰胺和 D-谷氨酸、精氨酸、脯氨酸、组氨酸和丙酮酸的代谢方面存在差异。入住 ICU 的 COVID-19 ARDS (C19/A) 患者的苯丙氨酸、色氨酸、赖氨酸和酪氨酸代谢特征与未入住 ICU 的 COVID-19 肺炎 (C19/P) 患者的代谢特征不同。代谢组学分析显示，C19/A、H1N1/A 和 PNA/A 与 ICU 通气对照之间存在显着差异，反映了潜在不同的疾病机制。不同的代谢表型是与不同病毒和细菌感染相关的 ARDS 的特征。