Respiratory failure & ventilation
Molecular Phenotypes of Acute Respiratory Distress Syndrome in the ROSE Trial Have Differential Outcomes and Gene Expression Patterns That Differ at Baseline and Longitudinally over Time
Authors' conclusion
The hyperinflammatory and hypoinflammatory phenotypes have different clinical, protein, and dynamic transcriptional characteristics.
Study context
- Population
- Moderate to severe acute respiratory distress syndrome (ARDS) in the ROSE trial of cisatracuriumRNA-sequenced subset n = 134
- Comparison
- Hyperinflammatory vs hypoinflammatory ARDS phenotype
- Primary endpoint
- Molecular phenotypes by latent class analysis and their outcomes (mortality)
- Follow-up
- Day 90
Methodological detailslatent class analysis, whole-blood RNA sequencing subset
- Latent class analysis
- Whole-blood RNA sequencing subset
Primary result
As reported in the abstract
Phenotype prevalence and Day 90 mortality
Phenotype prevalence and Day 90 mortality
Prevalence
- Hyperinflammatory vs Hypoinflammatory: P < 0.0001 — higher mortality in hyperinflammatory phenotype
Further findings
Treatment interaction (phenotype × randomised group) for mortality
- No treatment interaction between phenotypes and randomised groups for mortality
Gene expression (whole-blood RNA) · Day 0 and Day 2
- Hyperinflammatory enriched for innate immune response, tissue remodelling and zinc metabolism genes at Day 0, collagen synthesis and neutrophil degranulation at Day 2
- Longitudinal gene expression changes differed by survivorship
- Most highly expressed genes correlated with plasma protein abundance; class-defining plasma proteins did not correlate with their genes' expression
Original publication
Molecular Phenotypes of Acute Respiratory Distress Syndrome in the ROSE Trial Have Differential Outcomes and Gene Expression Patterns That Differ at Baseline and Longitudinally over Time. Am J Respir Crit Care Med. Published 1 April 2024. doi:10.
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