From inflammation to innovation: Exploring the emerging roles of itaconate in ARDS

Acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure characterized by diffuse alveolar damage, pulmonary edema, and decreased lung compliance. It represents the most severe manifestation of acute lung injury (ALI). Conditions such as sepsis, acute pancreatitis, and trauma are well-recognized triggers of ALI/ARDS. Given the high mortality rate and limited therapeutic options, current management strategies primarily rely on lung-protective ventilation, careful fluid management, and pharmacological interventions. Consequently, there is an urgent need to develop novel and more effective therapeutic approaches. Itaconate, a metabolite generated during immune cell activation, exhibits potent anti-inflammatory and antioxidant properties. Emerging evidence suggests that itaconate confers protective effects in various inflammatory diseases. This review explores the mechanisms and functions of itaconate in the context of ARDS, providing new insights into its potential as a therapeutic agent.