Insights from NMR - based metabolomics elucidates key metabolic dysregulation in pancreatitis-induced acute respiratory distress syndrome: A step towards precision medicine.

Acute respiratory distress syndrome (ARDS), a life-threatening pulmonary dysfunctional condition marked by hypoxemia, is a leading cause of high mortality in critically ill patients. Despite its clinical significance, the metabolic disruptions underlying ARDS, particularly in the context of severe acute pancreatitis (SAP), need further understanding. This study employed Nuclear Magnetic Resonance (NMR)-based metabolomics to investigate serum samples from 92 intensive care unit (ICU) patients, 27 with SAP-induced ARDS and 65 patients with ARDS due to other aetiologies. Multivariate and univariate statistical analyses were utilized to distinguish the metabolic profile between these groups. The study identified delineation in 13 significant metabolites and metabolic pathways corresponding to severity in ARDS patients due to SAP. Decreased levels of proline and glucose, along with increased levels of 3-Hydroxybutyrate (3-HB), citrate, lactate and branched-chain amino acids (BCAAs) were identified. The findings of this study may provide potential biomarkers to facilitate early diagnosis, guide prognosis, and support the development of novel therapeutic interventions, which, aligned with established ICU guidelines, could contribute to improved patient outcomes in ARDS induced by SAP.