Elevated serum peroxiredoxin 1 is a biomarker of multiorgan failure in ARDS

Acute respiratory distress syndrome (ARDS) is a heterogeneous clinical syndrome with high morbidity and mortality. Despite advances in understanding its pathophysiology, definitive biomarkers for ARDS disease stratification and management remain lacking. This study evaluated the utility of circulating PRDX1 in predicting 28-day mortality in ARDS patients.

A retrospective cohort study was conducted at Third Xiangya Hospital, enrolling 90 ARDS patients. Serum PRDX1 levels and clinical data were collected and compared with those from healthy volunteers and non-ARDS pneumonia patients to examine its alterations in ARDS patients; multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were then employed to assess the prognostic value of circulating PRDX1 for 28-day mortality. An independent validation cohort of 20 ARDS patients was recruited from Xiangya Hospital intensive care units. Additionally, serum Prdx1 dynamics were assessed in LPS-induced acute lung injury (ALI) and sepsis-associated ALI murine models.

Serum PRDX1 levels were significantly elevated in a cohort of 90 ARDS patients, particularly among those with multiorgan injury. Multivariate analysis identified PRDX1 and age as independent risk factors for 28-day mortality. ROC curves revealed PRDX1's prognostic utility (area under the curve, AUC=0.776, p<0.0001), which was comparable to the APACHE II score (AUC=0.778, p<0.0001). These findings were validated in the 20-patient cohort. Animal experiments confirmed that serum PRDX1 positively correlated with lung injury severity and exhibited earlier elevation and higher abundance in multiorgan injury contexts.

Serum PRDX1 was significantly elevated in ARDS patients, particularly in those with multiorgan injury, and demonstrated potential as a prognostic biomarker, showing correlation with 28-day mortality. Its integration into the ARDS management framework holds significant potential for improving clinical outcomes.