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Summary  Background The relationship between acute respiratory distress syndrome (ARDS)/acute lung injury (ALI) and levels of certain inflammatory factors remains controversial. The purpose of this meta-analysis was to summarize the available studies evaluating the association between levels of inflammatory factors and ARDS/ALI incidence. Methods We searched the PubMed, EmBase, and Cochrane databases for studies published up to July 2017. For each inflammatory factor, a random effects model was employed to pool results from different studies. Results We identified 63 studies that included 6243 patients in our meta-analysis. Overall, the results indicated that the levels of angiopoietin (ANG)-2 (standard mean difference, SMD: 1.34;  P  &lt; 0.001), interleukin (IL)-1β (SMD: 0.92;  P  = 0.012), IL‑6 (SMD: 0.66;  P  = 0.005), and tumor necrosis factor (TNF)-α (SMD: 0.98;  P  = 0.001) were significantly higher in patients with ARDS/ALI than in unaffected individuals. No significant differences were observed between patients with ARDS/ALI and unaffected individuals in terms of the levels of IL‑8 (SMD: 0.61;  P  = 0.159), IL-10 (SMD: 1.10;  P  = 0.231), and plasminogen activator inhibitor (PAI)-1 (SMD: 0.70;  P  = 0.060). Conclusions ARDS/ALI is associated with a significantly elevated levels of ANG‑2, IL-1β, IL‑6, and TNF‑α, but not with IL‑8, IL-10, and PAI‑1 levels.

Association between inflammatory biomarkers and acute respiratory distress syndrome or acute lung injury risk