New perspective on sepsis

April 17, 2014

In a review published in the April issue of Immunity, Kevin J. Tracey, MD, president of The Feinstein Institute for Medical Research, says it's time to take a fresh look at the medical community's approach to treating sepsis, which kills millions worldwide every year, including more than 200,000 Americans.

Sepsis occurs when molecules released into the bloodstream to fight an injury or infection trigger inflammation throughout the body. Inflammation is necessary for maintaining good health – without inflammation, wounds and infections would never be controlled or heal. However, persistent and constant inflammation often results in organ dysfunction or damage, leading to death – 28 to 50 percent of people who suffer from die from the condition. In addition to the toll in human lives, sepsis costs healthcare systems billions of dollars each year – much of the costs attributed to expenses incurred during weeks or months-long stays in intensive care units.

The review, co-written by Dr. Tracey and Clifford S. Deutschman, professor of Anesthesiology and Critical Care at the University of Pennsylvania, notes that unlike other major epidemic illnesses, treatment for sepsis is nonspecific and limited primarily to support of organ function and administration of intravenous fluids, antibiotics and oxygen. There are no approved drugs that specifically target sepsis. They argue that to develop therapeutic options that treat sepsis, a new approach might be needed.

Sepsis, Drs. Tracey and Deutschman wrote, "is not a stereotypical, steadily progressive immunological process that follows infection or injury; that innate and adaptive immune responses do not inevitably damage host cells; and that the long-held notion that sepsis is a distinct immunological disorder is incorrect. Rather, understanding sepsis requires reframing the research focus to identify immunometabolic and neurophysiological mechanisms of cellular and organ dysfunction."

The review explains that and persistent critical illness (PCI), which result in that lasts for weeks or months, are not immunopathologies as previously thought. Immunopathology is a branch of medicine that deals with immune responses associated with disease. It includes the study of the pathology of an organism, organ system, or disease with respect to the immune system, immunity, and immune responses. Much of the efforts to treat sepsis have been focused in this area. Although much has been learned about sepsis and PCI as a result, this approach has not led to any currently approved targeted treatment.

Recent discoveries indicate that severe sepsis and PCI are not caused by immune system dysfunction alone, but also by a failure of homeostasis – a failure in the body to maintain stability of its internal environment in response to changes in external conditions. Now that researchers know this, it will be crucially important to study aspects of homeostasis, including the deregulation of metabolism, neural reflexes, energy utilization and cell stress. Greater understanding in these areas has potential for resulting in improved and effective treatment for severe sepsis and PCI.

Explore further: Researchers discover plant derivative

More information: Review in Immunity: ac.els-cdn.com/S1074761314001150/1-s2.0-S1074761314001150-main.pdf

Related Stories

Researchers discover plant derivative

November 15, 2012

Researchers at The Feinstein Institute for Medical Research have discovered that tanshinones, which come from the plant Danshen and are highly valued in Chinese traditional medicine, protect against the life-threatening condition ...

Are we closer to understanding the cause of deadly sepsis?

November 16, 2012

Following an infection, dysregulation of the immune system can result in a systemic inflammatory response and an often fatal condition called severe sepsis or septic shock. Sepsis is not uncommon, yet its cause and underlying ...

Study shows decrease in sepsis mortality rates

November 13, 2013

A recent study from Boston University School of Medicine (BUSM) and Boston Medical Center (BMC) shows a significant decrease in severe sepsis mortality rates over the past 20 years. Looking at data from patients with severe ...

Research identifies potential new treatment for sepsis

November 14, 2013

Sepsis is the leading cause of in-hospital death and there is no specific treatment for it. Now, research led by Dr. Qingping Feng of Western University (London, Canada) suggests a protein called recombinant human annexin ...

Recommended for you

Epigenomic changes are key to innate immunological memory

August 31, 2015

A research team led by Keisuke Yoshida and Shunsuke Ishii of the RIKEN Molecular Genetics Laboratory has revealed that epigenomic changes induced by pathogen infections, mediated by a transcription factor called ATF7, are ...

Team finds early inflammatory response paralyzes T cells

August 18, 2015

In a discovery that is likely to rewrite immunology text books, researchers at UC Davis have found that early exposure to inflammatory cytokines, such as interleukin 2, can "paralyze" CD4 T cells, immune components that help ...

SIV shrugs off antibodies in vaccinated monkeys

August 11, 2015

New research on monkeys vaccinated against HIV's relative SIV calls into question an idea that has driven AIDS vaccine work for years. The assumption: a protective vaccine only needs to stimulate moderate levels of antibodies ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.