Endotype Identification in Pediatric ARDS
Principle Investigator: Brian Varisco, MD
Pediatric Acute Respiratory Distress Syndrome (PARDS) is an acute lung injury that can develop after acute illnesses, such as sepsis, trauma, pneumonia, and other conditions. Recent work has shown that gene programs active in the nasal epithelium closely parallel those in the more distal lung epithelium allowing noninvasive diagnosis and classification of heterogeneous respiratory diseases such as asthma, lung cancer, and COPD.
We are using nasal epithelial cell transcriptomics to identify PARDS endotypes--biologically distinct subclasses of a diseases which are clinically indistinguishable. We are working to establish the nasal gene expression profile of control PICU patients without lung disease, identify nasal epithelial cell gene-expression-based PARDS endotypes, and determine how this endotype data should be integrated with published biomarkers. In addition, we are collecting nasal samples collected on days 3, 7, and 14 to identify temporal patterns of gene expression in resolving vs. non-resolving PARDS to better understand PARDS pathobiology. The data generated by this project will inform a larger, multicenter study to more definitively define PARDS endotypes (R34) and then test and validate the clinical significance of these endotypes (R01).