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Metabolomics profiles show elevated phenylalanine and lactate alongside depleted sphingosine 1-phosphate and citrulline in ARDS patientsMetabolomics profiles reveal metabolic signatures in patients with acute respiratory distress syndrome

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Key Takeaway
Note elevated phenylalanine and lactate alongside depleted sphingosine 1-phosphate and citrulline in ARDS patients.

This systematic review and meta-analysis investigates metabolic ARDS signatures by comparing metabolomics profiles between patients with acute respiratory distress syndrome and those without ARDS. The scope of the review focuses on identifying distinct metabolic patterns associated with the condition rather than evaluating treatment efficacy or safety outcomes.

The key findings indicate that phenylalanine levels are elevated in the ARDS group. Additionally, lactate levels are found to be elevated. Conversely, sphingosine 1-phosphate levels are depleted, and citrulline levels are also depleted in patients with ARDS compared to the control group. No specific effect sizes, absolute numbers, or p-values were reported for these outcomes.

Important limitations include the fact that the sample size was not reported and the study setting was not reported. Safety data, including adverse events and tolerability, were not reported. The review does not establish causality, and the authors do not overstate the certainty of these metabolic associations. Practice relevance regarding clinical application was not reported.

Patients with acute respiratory distress syndrome face a life-threatening struggle to breathe. This condition causes severe lung injury and low oxygen levels. A recent analysis looked at chemical patterns in the blood of these patients to understand what happens inside their bodies during this crisis. The researchers compared the blood chemistry of people with the disease to those who did not have it. They found clear differences in how the body processes nutrients and energy during this illness.

Specific chemicals showed distinct changes. Levels of phenylalanine and lactate were higher in patients with the condition. At the same time, levels of sphingosine 1-phosphate and citrulline were lower. These findings suggest that the body uses energy and builds molecules differently when fighting this severe lung problem. The study looked at a group of patients with acute respiratory distress syndrome and those without it to spot these patterns.

While these chemical signatures are new, the study did not test a treatment. It simply identified these metabolic markers. The results offer a window into the disease process but do not yet guide clinical decisions. More research is needed to see if these patterns can help doctors predict outcomes or tailor care for patients in the intensive care unit.

What this means for you:
Blood chemistry shows specific metabolic changes in patients with acute respiratory distress syndrome.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedJun 2026
View Original Abstract ↓
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a severe condition with high mortality, despite the absence of metabolomics biomarkers validated for its pathophysiological features. This systematic review and meta-analysis aim to identify robust metabolic ARDS signatures. METHODS: Following PRISMA guidelines, we searched PubMed, Embase, Web of Science, OVID, and Cochrane Library up to March 2025. Case-control studies comparing metabolomics profiles between patients with ARDS and those without ARDS were included. Study quality and risk of bias were assessed using the Newcastle-Ottawa Scale and the NTP/OHAT tool. Random-effects meta-analyses of standardized mean differences were performed with subgroup and sensitivity analyses, while pathway enrichment was conducted as a separate component of the biological evaluation. RESULTS: Phenylalanine and lactate levels were elevated in ARDS patients, whereas sphingosine 1-phosphate and citrulline were depleted. Pathway analysis reveals eight disrupted networks, including arginine biosynthesis and glyoxylate metabolism, with "amino acids/peptides" driving the predominant alterations. CONCLUSION: This study illustrates metabolic reprogramming as a hallmark of ARDS pathogenesis, linking amino acid and lipid imbalances to inflammation and vascular dysfunction. The findings emphasise the importance of platform harmonization and the potential of biomarker research.
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