Abstract
The validation of biomarkers has become a key goal of translational biomedical research. The purpose of this article is to discuss the role of biomarkers in the management of acute lung injury (ALI) and related research. Biomarkers should be sensitive and specific indicators of clinically important processes and should change in a relevant timeframe to affect recruitment to trials or clinical management. We do not believe that they necessarily need to reflect pathogenic processes. We critically examined current strategies used to identify biomarkers and which, owing to expedience, have been dominated by reanalysis of blood derived markers from large multicenter Phase 3 studies. Combining new and existing validated biomarkers with physiological and other data may add predictive power and facilitate the development of important aids to research and therapy.
Highlights
The syndrome acute lung injury (ALI) and its more severe counterpart acute respiratory distress syndrome (ARDS) are defined by radiographic and physiological changes that characterize patients with acute lung failure (Table 1) [1]
Survivors face a long-term reduction in quality of life; for example, only 54% of survivors were able to return to work 12 months after hospital discharge [3]
The purpose of this article is to discuss the role of biomarkers in the management of ALI and related research
Summary
The syndrome acute lung injury (ALI) and its more severe counterpart acute respiratory distress syndrome (ARDS) are defined by radiographic and physiological changes that characterize patients with acute lung failure (Table 1) [1]. All age groups may be affected, the syndrome has a higher incidence and mortality in older people. Across all ages the incidence is approximately 200,000 cases per year in the United States with a mortality of around 35% [2]. The validation of biomarkers, for use in clinical trials and in practice, has become a central tenet of translational biomedical research [4]. The purpose of this article is to discuss the role of biomarkers in the management of ALI and related research. We shall not present a state of the art review of the field of all the biomarkers that have been investigated in this field, excellent examples of which have been produced recently [5,6]. We shall question current strategies to identify biomarkers and whether what has been achieved far has advanced the field
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