Acute respiratory distress syndrome (ARDS) is a heterogeneous cause of respiratory failure that has a rapid onset, a high mortality rate, and for which there is no effective pharmacological treatment. Current evidence supports a critical role of excessive inflammation in ARDS, resulting in several cytokines, cytokine receptors, and proteins within their downstream signalling pathways being putative therapeutic targets. However, unsuccessful trials of anti-inflammatory drugs have thus far hindered progress in the field. In recent years, the prospects of precision medicine and therapeutic targeting of cytokines coevolving into effective treatments have gained notoriety. There is an optimistic and growing understanding of ARDS subphenotypes as well as advances in treatment strategies and clinical trial design. Furthermore, large trials of anti-cytokine drugs in patients with COVID-19 have provided an unprecedented amount of information that could pave the way for therapeutic breakthroughs. While current clinical and nonclinical ARDS research suggest relatively limited potential in monotherapy with anti-cytokine drugs, combination therapy has emerged as an appealing strategy and may provide new perspectives on finding safe and effective treatments. Accurate evaluation of these drugs, however, also relies on well-founded experimental research and the implementation of biomarker-guided stratification in future trials. In this review, we provide an overview of anti-cytokine therapy for acute lung injury and ARDS, highlighting the current preclinical and clinical evidence for targeting the main cytokines individually and the therapeutic prospects for combination therapy.

急性呼吸窘迫综合征（ARDS）是一种引起呼吸衰竭的异质性原因，发病迅速、死亡率高，且尚无有效的药物治疗方法。目前的证据支持过度炎症在 ARDS 中发挥关键作用，导致下游信号通路中的多种细胞因子、细胞因子受体和蛋白质成为假定的治疗靶点。然而，迄今为止，抗炎药物的不成功试验阻碍了该领域的进展。近年来，精准医疗和细胞因子治疗靶向共同发展为有效治疗的前景已广为人知。人们对 ARDS 亚表型的理解越来越乐观，治疗策略和临床试验设计也取得了进展。此外，针对 COVID-19 患者的抗细胞因子药物的大型试验提供了前所未有的大量信息，可以为治疗突破铺平道路。虽然目前的临床和非临床 ARDS 研究表明抗细胞因子药物单一疗法的潜力相对有限，但联合疗法已成为一种有吸引力的策略，并可能为寻找安全有效的治疗方法提供新的视角。然而，对这些药物的准确评估还依赖于有充分依据的实验研究以及在未来试验中生物标志物引导分层的实施。在这篇综述中，我们概述了急性肺损伤和ARDS的抗细胞因子治疗，强调了目前单独针对主要细胞因子的临床前和临床证据以及联合治疗的治疗前景。