Identifying molecular phenotypes in sepsis: an analysis of two prospective observational cohorts and secondary analysis of two randomised controlled trials.

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Abstract

In sepsis and acute respiratory distress syndrome (ARDS), heterogeneity has contributed to difficulty identifying effective pharmacotherapies. In ARDS, two molecular phenotypes (hypoinflammatory and hyperinflammatory) have consistently been identified, with divergent outcomes and treatment responses. In this study, we sought to derive molecular phenotypes in critically ill adults with sepsis, determine their overlap with previous ARDS phenotypes, and evaluate whether they respond differently to treatment in completed sepsis trials.

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Journal

Journal ID (iso-abbrev): Lancet Respir Med

Title: The Lancet. Respiratory medicine

Publisher: Elsevier BV

ISSN (Electronic): 2213-2619

ISSN (Print): 2213-2600

Publication date (Electronic): Nov 2023

Volume: 11

Issue: 11

Affiliations

[1 ] Division of Clinical and Translational Research, Division of Critical Care, Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, USA. Electronic address: p.sinha@wustl.edu.

[2 ] Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.

[3 ] Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.

[4 ] Department of Medicine, University of California San Francisco, San Francisco, CA, USA.

[5 ] Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Cardiovascular Research Institute, University of California San Francisco, San Francisco, CA, USA.

[6 ] Division of Infectious Diseases, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Chan Zuckerberg Biohub, San Francisco, CA, USA.

[7 ] Division of Clinical and Translational Research, Division of Critical Care, Department of Anesthesiology, Washington University School of Medicine, Saint Louis, MO, USA.

[8 ] Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA.

[9 ] Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA.

[10 ] Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, CA, USA.

[11 ] Division of Hospital Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.

[12 ] Department of Medicine, Division of Critical Care Medicine, Robarts Research Institute, University of Western Ontario, London, ON, Canada.

[13 ] Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.

[14 ] Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Division of Nephrology, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.

[15 ] Division of Critical Care Medicine, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada; Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada.

[16 ] Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA; Department of Anesthesia, University of California San Francisco, San Francisco, CA, USA.

[17 ] Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.

Article

Publisher Item ID: S2213-2600(23)00237-0

DOI: 10.1016/S2213-2600(23)00237-0

PubMed ID: 37633303

SO-VID: f1694109-532d-4b84-828c-092a0b68349e

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