Acute respiratory distress syndrome (ARDS), manifested by intricate etiology and pathophysiology, demands careful clinical surveillance due to its high mortality and imminent life support measures. NMR based metabolomics provides an approach for ARDS which culminates from a wide spectrum of illness thereby confounding early manifestation and prognosis predictors. 1 H NMR with its manifold applications in critical disease settings can unravel the biomarker of ARDS thus holding potent implications by providing surrogate endpoints of clinical utility. NMR metabolomics which is the current apogee platform of omics trilogy is contributing towards the possible panacea of ARDS by subsequent validation of biomarker credential on larger datasets. In the present review, the physiological derangements that jeopardize the whole metabolic functioning in ARDS are exploited and the biomarkers involved in progression are addressed and substantiated. The following sections of the review also outline the clinical spectrum of ARDS from the standpoint of NMR based metabolomics which is an emerging element of systems biology. ARDS is the main premise of intensivists textbook, which has been thoroughly reviewed along with its incidence, progressive stages of severity, new proposed diagnostic definition, and the preventive measures and the current pitfalls of clinical management. The advent of new therapies, the need for biomarkers, the methodology and the contemporary promising approaches needed to improve survival and address heterogeneity have also been evaluated. The review has been stepwise illustrated with potent biometrics employed to selectively pool out differential metabolites as diagnostic markers and outcome predictors. The following sections have been drafted with an objective to better understand ARDS mechanisms with predictive and precise biomarkers detected so far on the basis of underlying physiological parameters having close proximity to diseased phenotype. The aim of this review is to stimulate interest in conducting more studies to help resolve the complex heterogeneity of ARDS with biomarkers of clinical utility and relevance.

中文翻译：

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从代谢生物标志物的角度出发，基于NMR的急性呼吸窘迫综合征（ARDS）异质生物学全景图。

复杂的病因和病理生理表现为急性呼吸窘迫综合征（ARDS），由于其高死亡率和迫在眉睫的生命支持措施，需要进行仔细的临床监测。基于NMR的代谢组学为ARDS提供了一种方法，该方法最终可导致多种疾病，从而混淆了早期表现和预后预测因素。1 H NMR及其在关键疾病环境中的多种应用可以揭示ARDS的生物标记，从而通过提供临床实用性的替代终点而具有潜在的意义。核磁共振代谢组学是当前的组学三部曲的远地点平台，通过随后在更大的数据集上验证生物标志物凭证，正在为ARDS的灵丹妙药做出贡献。在目前的评论中，利用危及ARDS整体代谢功能的生理紊乱，解决并证实了与进展有关的生物标志物。综述的以下部分还从基于NMR的代谢组学的角度概述了ARDS的临床范围，这是系统生物学的新兴元素。ARDS是强化治疗师教科书的主要前提，对它的发生率，严重程度的进展阶段，新提出的诊断定义以及预防措施和临床管理的当前缺陷进行了彻底的审查。还评估了新疗法的出现，对生物标志物的需求，方法学以及提高生存率和应对异质性所需的当代有前途的方法。综述已通过有效的生物测定技术逐步说明，该生物测定技术用于选择性地收集不同的代谢产物作为诊断标志物和结果预测指标。起草以下各节的目的是更好地了解到目前为止，根据与疾病表型非常接近的潜在生理参数检测到的具有预测性和精确性生物标志物的ARDS机制。这篇综述的目的是激发人们进行更多研究的兴趣，以帮助解决具有临床实用性和相关性的生物标志物对ARDS的复杂异质性。起草以下各节的目的是更好地了解到目前为止，根据与疾病表型非常接近的潜在生理参数检测到的具有预测性和精确性生物标志物的ARDS机制。这篇综述的目的是激发人们进行更多研究的兴趣，以帮助解决具有临床实用性和相关性的生物标志物对ARDS的复杂异质性。起草以下各节的目的是更好地了解到目前为止，根据与疾病表型非常接近的潜在生理参数检测到的具有预测性和精确性生物标志物的ARDS机制。这篇综述的目的是激发人们进行更多研究的兴趣，以帮助解决具有临床实用性和相关性的生物标志物对ARDS的复杂异质性。