Evidence map›Paper›PMID 41646785›Full record

ArticlemedRxiv : the preprint server for health sciences2026

Alveolar Immune Profiling Identifies Distinct Subphenotypes of Acute Respiratory Failure.

Eric D Morrell, Ted Liu, Marika Orlov, Leonoor S Boers, Neha A Sathe, Chelsea Schmitz, Mallorie Mitchem, Anne Chaize, Lucy Y Gao, Francis L Mabrey and 10 more

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Eric D MorrellUniversity of Washington, Seattle, WA, USA.
Ted LiuUniversity of Washington, Seattle, WA, USA.
Marika OrlovUniversity of Colorado, Aurora, CO, USA.
Leonoor S BoersAmsterdam University Medical Center, Location University of Amsterdam, the Netherlands.
Neha A SatheUniversity of Washington, Seattle, WA, USA.
Chelsea SchmitzUniversity of Washington, Seattle, WA, USA.
Mallorie MitchemBenaroya Research Institute, Seattle, WA, USA.
Anne ChaizeBenaroya Research Institute, Seattle, WA, USA.
Lucy Y GaoUniversity of Washington, Seattle, WA, USA.
Francis L MabreyUniversity of Washington, Seattle, WA, USA.
Sarah E HoltonUniversity of Washington, Seattle, WA, USA.
Pavan K BhatrajuUniversity of Washington, Seattle, WA, USA.
Akram KhanOregon Health and Science University, Portland, OR, USA.
Catherine L HoughOregon Health and Science University, Portland, OR, USA.
Renee D StapletonUniversity of Vermont, Burlington, VT, USA.
Hélène van den HeuvelAmsterdam University Medical Center, Location University of Amsterdam, the Netherlands.
JanWillem DuitmanAmsterdam University Medical Center, Location University of Amsterdam, the Netherlands.
Lieuwe D J BosAmsterdam University Medical Center, Location University of Amsterdam, the Netherlands.
Mark M WurfelUniversity of Washington, Seattle, WA, USA.
Carmen MikacenicBenaroya Research Institute, Seattle, WA, USA.

Funding

Immune Checkpoints in Acute Respiratory Distress Syndrome (IC-ARDS)R01HL149676 · NHLBI · BENAROYA RESEARCH INST AT VIRGINIA MASON · PI MIKACENIC, CARMEN R · 2020 to 2024
$3.0M
Alveolar macrophage subset ontogeny and differentiation during ARDSR01HL169265 · NHLBI · UNIVERSITY OF WASHINGTON · PI Eric Douglas Morrell · 2024 to 2026
$2.1M
Targeting Angiopoietin-like 4 (ANGPTL4) in Severe Community Acquired PneumoniaR01HL172872 · NHLBI · UNIVERSITY OF WASHINGTON · PI William A Altemeier, Pavan Kumar Bhatraju · 2025 to 2026
$1.6M
The Role of Alveolar Mononuclear Phagocytes in Acute Respiratory Distress SyndromeK23HL144916 · NHLBI · UNIVERSITY OF WASHINGTON · PI MORRELL, ERIC DOUGLAS · 2019 to 2023
$951k
Determining the role of CD163+ blood monocytes and lung macrophages in Progressive Pulmonary FibrosisK23HL175120 · NHLBI · UNIVERSITY OF WASHINGTON · PI Sarah Elizabeth Holton · 2025 to 2026
$378k
NHLBI NIH HHS K23 HL144916NHLBI NIH HHS K23 HL175120NHLBI NIH HHS R01 HL149676NHLBI NIH HHS R01 HL169265NHLBI NIH HHS R01 HL172872
6 · The paper itself

Abstract

Acute respiratory failure causes millions of deaths worldwide each year, highlighting the need for a better understanding of its pathophysiology and approaches to identify treatment-responsive subphenotypes of patients. Although subphenotypes of acute respiratory failure have been described using peripheral blood biomarkers, it remains unclear whether lung-specific molecular profiles can define biologically and clinically meaningful subphenotypes. In this study, we identified four distinct subphenotypes based on the measurement of twenty-five soluble proteins in alveolar fluid collected from 466 patients with acute respiratory failure. Forty-eight of these participants also underwent immunophenotyping by spectral flow cytometry to characterize immune cell populations. Twenty-eight-day mortality was significantly different across the four subphenotypes. The subphenotype with lowest mortality (12.7%) showed elevated levels of soluble PD-L1, enrichment of T cell-related chemokines, and the highest proportion of memory CD8

Identifiers

PMID41646785
PMCPMC12870558

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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 OpenQuestion graph.