SynthesisThorax2024
Elevated ferritin, mediated by IL-18 is associated with systemic inflammation and mortality in acute respiratory distress syndrome (ARDS).
Synthesis in Thorax, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 17 citations in OpenAlex.
- Evaluating plasma ferritin and suPAR as treatable traits for critically ill patients with COVID-19 treated with anakinra: an exploratory analysis of the immune modulation domain of the REMAP-CAP randomised clinical trial.Critical care (London, England) · 2026Observational
- The Acute Respiratory Distress Syndrome (ARDS): epidemiology, etiology, molecular mechanisms, diagnosis and therapeutic strategies.Molecular biomedicine · 2026Review
- Cytokine-based strategies to improve prognostic enrichment of pediatric ARDS.Critical care (London, England) · 2026Observational
- Targeting macrophage ferritin heavy chain mitigates ferroptosis and lung injury in experimental acute respiratory distress syndrome.Nature communications · 2026Article
- Normoferritinemic Versus Hyperferritinemic Inflammation in Patients Admitted to the Department of Internal Medicine.Journal of clinical medicine · 2026Article
- Targeted deletion of macrophage ferritin heavy chain protects from macrophage ferroptosis in acute respiratory distress syndrome.Research square · 2026Article
- The plasma metabolite-mediated relationship between inflammatory cytokines and acute respiratory distress syndrome.Archives of medical science : AMS · 2026Article
- Lung Microphysiological System Validates Novel Cell Therapy for Acute Respiratory Distress Syndrome.Advanced biology · 2026Article
- YOD1 promotes ferroptosis in acute lung injury by deubiquitination of NCOA4.Communications biology · 2025Article
- Is Mechanical Power the Trojan Horse? Emphasizing the Role of Driving Pressure.Medicina (Kaunas, Lithuania) · 2025Article
- Increasing inflammatory biomarkers are associated with mortality in critically ill COVID-19 patients despite anti-inflammatory treatment.Clinical and experimental medicine · 2025Observational
- The inflammasome adaptor pycard is essential for immunity against Mycobacterium marinum infection in adult zebrafish.Disease models & mechanisms · 2025Article
- Acute lung injury: pathogenesis and treatment.Journal of translational medicine · 2025Review
- Heme-induced lung injury in human precision cut lung slices: a new model for acute lung injury.Respiratory research · 2025Article
- Inflammatory Biomarkers Demonstrate Predictive Capacity for Mortality in COVID-19-Related ARDS Patients Receiving High-Dose Corticosteroids: A Longitudinal Analysis.Journal of inflammation research · 2025Article
- Ferroptosis in sepsis induced acute lung injury/acute respiratory distress syndrome (ALI/ARDS): a potential therapeutic strategy.Frontiers in immunology · 2025Review
- IL-18 and IL-18BP: A Unique Dyad in Health and Disease.International journal of molecular sciences · 2024Review
- Identifying a hyperinflammatory subphenotype of ARDS associated with worse outcomes: may ferritin help?Thorax · 2024Article
- The independent predictive value of admission serum ferritin concentration for prognosis in elderly patients with community-acquired pneumonia in the emergency department.Frontiers in cellular and infection microbiology · 2024Article
- Heart-lung crosstalk in acute respiratory distress syndrome.Frontiers in physiology · 2024Review
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundInflammatory subphenotypes have been identified in acute respiratory distress syndrome (ARDS). Hyperferritinaemia in sepsis is associated with hyperinflammation, worse clinical outcomes, and may predict benefit with immunomodulation. Our aim was to determine if raised ferritin identified a subphenotype in patients with ARDS.
methodsBaseline plasma ferritin concentrations were measured in patients with ARDS from two randomised controlled trials of simvastatin (Hydroxymethylglutaryl-CoA Reductase Inhibition with Simvastatin in Acute Lung Injury to Reduce Pulmonary Dysfunction-2 (HARP-2); discovery cohort, UK) and neuromuscular blockade (ROSE; validation cohort, USA). Results were analysed using a logistic regression model with restricted cubic splines, to determine the ferritin threshold associated with 28-day mortality.
resultsFerritin was measured in 511 patients from HARP-2 (95% of patients enrolled) and 847 patients (84% of patients enrolled) from ROSE. Ferritin was consistently associated with 28-day mortality in both studies and following a meta-analysis, a log-fold increase in ferritin was associated with an OR 1.71 (95% CI 1.01 to 2.90) for 28-day mortality. Patients with ferritin >1380 ng/mL (HARP-2 28%, ROSE 24%) had a significantly higher 28-day mortality and fewer ventilator-free days in both studies. Mediation analysis, including confounders (acute physiology and chronic health evaluation-II score and ARDS aetiology) demonstrated a statistically significant contribution of interleukin (IL)-18 as an intermediate pathway between ferritin and mortality.
conclusionsFerritin is a clinically useful biomarker in ARDS and is associated with worse patient outcomes. These results provide support for prospective interventional trials of immunomodulatory agents targeting IL-18 in this hyperferritinaemic subgroup of patients with ARDS.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.