STARDUST: The significance of different endotypes of Adult Respiratory Distress Syndrome (ARDS) for effective treatment
Acute Respiratory Distress Syndrome (ARDS) is a severe lung disorder with a high mortality rate, which often occurs in previously healthy individuals. A number of heterogenous causes are known to lead to ARDS, including sepsis (severe infection with affection of other organs and hemodynamic as well as cardiovascular system), pulmonary infection (pneumonia), shock, trauma or burns, blood transfusion and aspiration (stomach content in lungs).
ARDS was first described in 1967, with 2017 marking the 50th anniversary of the characterisation of the disease. There have been very few critical accomplishments to celebrate during the last 5 decades – neither conclusive characterization of the syndrome nor specific treatments have been achieved, despite decades of comprehensive research.
Acute Respiratory Distress Syndrome Statistics
STARDUST Pilot STUDY
From retrospective cluster analysis of >4000 patients from 6 ARDS cohorts, there is increasing evidence that ARDS patients can be consistently differentiated into smaller subgroups (endotypes):
- Uninflamed endotype – no excessive inflammatory reaction; P1
- Hyperinflammatory endotype – showing a high inflammatory reaction; P2
The STARDUST study is aiming to further characterise these subgroups using large animal pre-clinical models. The CCRG team have developed an ovine model of the above endotypes and will explore the following as a part of the STARDUST project:
- Responses to treatment between the different endotypes, guiding towards personalisation of treatment that is endotype dependant; and
- Identifying ways to subgroup patients in a timely manner to improve patient outcome and surivial rates.
Dr Karin Wildi has led the team to successful completion of the STARDUST pilot study. The pilot has delivered very promising results that will be built upon as the main study progresses in October 2019.