A Pathophysiologic Approach to Biomarkers in Acute Respiratory Distress Syndrome

Table 1

Biomarkers of acute respiratory distress syndrome organized by phases and pathways of lung injury.

Pathophysiologic feature of ARDS	Biomarker	References
Exudative phase
Epithelium damage
(i) Alveolar type 1 cells	RAGE	[22–24]
	HTI56	[25, 26]
(ii) Alveolar type 2 cells	Surfactant	[27, 28]
	KL-6	[29, 30]
(iii) Clara cells	CC16	[31, 32]
Endothelium damage
	Ang-1, Ang-2	[33, 34]
	ICAM-1	[35, 138–140]
	Selectins	[36, 37]
	VEGF	[38, 39]
	vWF	[40–42]
Lung matrix alteration
	Laminin	[43, 44]
	Elastin/desmosine	[45, 46]
	MMPs	[47–49]
Inflammatory cascade
(i) Proinflammatory	IL-1β/TNF-α	[17, 161–164, 167]
	IL-18	[50, 51]
	IL-6	[52–55]
	IL-8	[169–171]
(ii) Anti-inflammatory	IL-1RA	[56, 57]
	sTNF-RI/sTNF-RII	[6, 54, 58]
	IL-10	[59–61]
(iii) Additional markers	HMGB1	[62, 63]
	LBP	[64, 65]
	NO	[46, 66, 67]
	CRP	[68]
	Albumin	[69]
	LDH	[69]
Coagulation and fibrinolysis
	PA-1	[32, 53, 70–72]
	Protein C	[75, 76, 182]
	Thrombomodulin	[73, 74]
	Tissue factor	[75–78]
	Cell-free hemoglobin	[75, 76, 79, 80]
Pulmonary vascular permeability
	EF/PL ratio	[81, 82]
Fibroproliferative phase
Endothelial proliferation
	VEGF	[39, 83–86]
Epithelial proliferation
	KGF	[87]
	HGF	[88, 194, 195, 197]
Epithelial apoptosis
	Fas/FasL	[25, 88–91]
Fibroblast proliferation
	N-PCP-III	[88, 194, 195, 203, 207]