Identification and Immune Cell Profiling of Exosome-related Genes in Acute Respiratory Distress Syndrome: An...

Acute respiratory distress syndrome (ARDS) is a life-threatening condition associated with high mortality and morbidity. However, targeted therapies that effectively improve patient outcomes remain limited. Exosomes play pivotal roles in intercellular communication and epigenetic regulation.

This study aimed to identify exosome-related differentially expressed genes (EXORDEGs) in whole blood associated with ARDS and to explore their potential mechanistic roles in the disease.

Two gene expression datasets (GSE32707 and GSE66890) were retrieved from the Gene Expression Omnibus for comprehensive bioinformatics analysis. Analytical approaches included Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses, protein-protein interaction network construction using the STRING database, and immune infiltration profiling via single-sample gene set enrichment analysis in relation to hub genes.

We identified 21 EXORDEGs, primarily enriched in biological processes such as endothelial cell development and apoptosis. Four hub genes-PI3, EEF1A1, ANAPC1, and PSMD2-were robustly associated with ARDS, with PSMD2 showing the most pronounced differential expression. Immune infiltration analysis revealed significant disparities in nine immune cell populations between ARDS and control samples.

The results of this comprehensive bioinformatics analysis identified four EXORDEGs-PI3, EEF1A1, ANAPC1, and PSMD2-with important roles in acute respiratory distress syndrome.

This study first systematically identified EXORDEGs in ARDS, discovering four hub genes and their associations with immune cells. The hub genes may be implicated in endothelial injury, inflammation, and immune dysregulation. These findings provide novel insights into ARDS pathogenesis and highlight potential therapeutic targets for further investigation. Given the disease heterogeneity, our findings primarily reflect common molecular characteristics, while the specific features of different etiological subtypes require further investigation.