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Review
. 2019 Aug 3;8(8):1163.
doi: 10.3390/jcm8081163.

Biomarkers of Acute Lung Injury The Individualized Approach: for Phenotyping, Risk Stratification and Treatment Surveillance

Daniel D Murray  1 , Theis Skovsgaard Itenov  1 , Pradeesh Sivapalan  2 , Josefin Viktoria Eklöf  2 , Freja Stæhr Holm  2 , Philipp Schuetz  3   4 , Jens Ulrik Jensen  5   6
Affiliations
Review

Biomarkers of Acute Lung Injury The Individualized Approach: for Phenotyping, Risk Stratification and Treatment Surveillance

Daniel D Murray et al. J Clin Med. .

Abstract

Do we need biomarkers of lung damage and infection: For what purpose and how should they be used properly? Biomarkers of lung damage can be used for diagnosis, risk stratification/prediction, treatment surveillance and adjustment of targeted therapy. Additionally, novel "omics" methods may offer a completely different and effective way of improving the understanding of pathogenesis of lung damage and a way to develop new candidate lung damage biomarkers. In the current review, we give an overview within the field of acute lung damage of (i) disease mechanism biomarkers, (ii) of "ready to use" evidence-based biomarker-guided lung infection management, (iii) of novel strategies of inflammatory phenotyping and how this can be used to tailor corticosteroid treatment, (iv) a future perspective of where "omics" technologies and mindsets may become increasingly important in developing new strategies for treatment and for understanding the development of acute lung damage.

Keywords: acute lung injury; biomarkers; omics.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Chance for “successful weaning” from a ventilator within 28 days in critically ill patients according to blood levels of lung injury biomarkers Surfactant Protein D and Gelsolin, adapted from Holm et al. [4]. Gelsolin categories are quartiles and “high-risk gelsolin” is the lowest quartile, “low-risk gelsolin” was the three remaining quartiles. “High-risk SPD” was the upper 15%-percentile, “low-risk SPD” were all other SPD measurements, according to Jensen et al. [1].
Figure 2
Figure 2
Suggestion of a PCT-guided antibiotic discontinuation algorithm based on Corti et al. [24].
Figure 3
Figure 3
Conceptualization of ‘Omics’ approach in acute lung injury.
See this image and copyright information in PMC

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