Vnitr Lek 2014, 60(1):68-72

The emerging pathogenesis-based strategies for treating sepsis

Lenka Ledvinová, Vojtěch Danihel, Martin Matějovič*
I. interní klinika LF UK a FN Plzeň, přednosta prof. MUDr. Martin Matějovič, Ph.D.
Biomedicínské centrum LF UK, Plzeň

The cornerstones of therapy for sepsis and septic shock remain the prompt and adequate hemodynamic resuscitation, administration of antibiotics that target the pathogen, removal or drainage of an infected source and organ support. Despite adequate treatment and advanced life-support, the mortality remains high. However, the development of adjunctive anti-sepsis therapies has been challenging, with more than 30 unsuccessful drug trials. Fortunately, recent advances in our understanding of the sepsis pathophysiology revealed new pathogenic paradigms, and, thus, provided new exciting therapeutic concepts. In this review, we briefly discuss emerging pathogenesis-based strategies for treating severe sepsis and septic shock.

Keywords: extracorporeal purification methods; immunosuppression; pathogenesis; sepsis; sepsis treatment

Received: July 26, 2013; Accepted: January 4, 2013; Published: January 1, 2014  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Ledvinová L, Danihel V, Matějovič M. The emerging pathogenesis-based strategies for treating sepsis. Vnitr Lek. 2014;60(1):68-72.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Xiao W, Mindrinos MN, Seok J et al. A genomic storm in critically injured humans. J Exp Med 2011; 208(13): 2581-2590. Go to original source... Go to PubMed...
    2. Cinel I, Opal SM. Molecular biology of inflammation and sepsis: a primer. Crit Care Med 2009; 37(1): 291-304. Go to original source... Go to PubMed...
    3. Cruz DN, Antonelli M, Fumagalli R et al. Early use of polymyxin B hemoperfusion in abdominal septic shock: the EUPHAS randomized controlled trial. JAMA 2009; 301(23): 2445-2452. Go to original source... Go to PubMed...
    4. Davies B, Cohen J. Endotoxin removal devices for the treatment of sepsis and septic shock. Lancet Infect Dis 2011; 11(1): 65-71. Go to original source... Go to PubMed...
    5. Opal SM, Laterre PF, Francois B et al. Effect of eritoran, an antagonist of MD2-TLR4, on mortality in patients with severe sepsis: the ACCESS randomized trial. JAMA 2013; 309(11): 1154-1162. Go to original source... Go to PubMed...
    6. Denk S, Perl M, Huber-Lang M. Damage- and pathogen-associated molecular patterns and alarmins: keys to sepsis? Eur Surg Res 2012; 48(4): 171-179. Go to original source... Go to PubMed...
    7. Yang H, Tracey KJ. Targeting HMGB1 in inflammation. Biochim Biophys Acta 2010; 1799(1-2): 149-156. Go to original source... Go to PubMed...
    8. Charchaflieh J, Wei J, Labaze G et al. The role of complement system in septic shock. Clin Dev Immunol 2012; 2012: 407324. Go to original source... Go to PubMed...
    9. Bosmann M, Ward PA. The inflammatory response in sepsis. Trends Immunol 2013; 34(3): 129-136. Go to original source... Go to PubMed...
    10. Souto FO, Alves-Filho JC, Turato WM et al. Essential role of CCR2 in neutrophil tissue infiltration and multiple organ dysfunction in sepsis. Am J Respir Crit Care Med 2011; 183(2): 234-242. Go to original source... Go to PubMed...
    11. Tracey KJ. Physiology and immunology of the cholinergic antiinflammatory pathway. J Clin Invest 2007; 117(2): 289-296. Go to original source... Go to PubMed...
    12. Sýkora R, Chvojka J, Kroužecký A et al. Hemoeliminační metody v léčbě sepse: současný stav. Vnitř Lék 2008; 54(10): 1000-1005. Go to PubMed...
    13. Payen D, Mateo J, Cavaillon JM et al. Impact of continuous venovenous hemofiltration on organ failure during the early phase of severe sepsis: a randomized controlled trial. Crit Care Med 2009; 37(3): 803-810. Go to original source... Go to PubMed...
    14. Rimmelé T, Kellum JA. Clinical review: blood purification for sepsis. Crit Care 2011; 15(1): 205. Go to original source... Go to PubMed...
    15. Sykora R, Chvojka J, Krouzecky A et al. High versus standard-volume haemofiltration in hyperdynamic porcine peritonitis: effects beyond haemodynamics? Intensive Care Med 2009; 35(2): 371-380. Go to original source... Go to PubMed...
    16. Sykora R, Chvojka J, Krouzecky A et al. Coupled plasma filtration adsorption in experimental peritonitis-induced septic shock. Shock 2009; 31(5): 473-480. Go to original source... Go to PubMed...
    17. Muriová K, Maláska J, Otevrel F et al. Myocardial dysfuncition in sepsis - definition and pathogenetic mechanisms. Vnitř Lék 2010; 56(3): 220-225. Go to PubMed...
    18. Stahl W, Matejovic M, Radermacher P. Inhibition of nitric oxide synthase during sepsis: revival because of isoform selectivity? Shock 2010; 34(3): 321-322. Go to original source... Go to PubMed...
    19. Singer M. Mitochondrial function in sepsis: acute phase versus multiple organ failure. Crit Care Med 2007; 35(9, Suppl): 441-448. Go to original source... Go to PubMed...
    20. Ruggieri AJ, Levy RJ, Deutschman CS. Mitochondrial dysfunction and resuscitation in sepsis. Crit Care Clin 2010; 26(3): 567-575. Go to original source... Go to PubMed...
    21. Boomer JS, To K, Chang KC et al. Immunosuppression in patients who die of sepsis and multiple organ failure. JAMA 2011; 306(23): 2594-2605. Go to original source... Go to PubMed...
    22. Hotchkiss RS, Monneret G, Payen D. Immunosuppression in sepsis: a novel understanding of the disorder and a new therapeutic approach. Lancet Infect Dis 2013; 13(3): 260-268. Go to original source... Go to PubMed...
    23. Karvunidis T, Lysák D, Chvojka J et al. Imunitní homeostáza (deregulace) v sepsi a septickém šoku. Anesteziologie a intenzivní medicína 2013; 24(4): 250-263.
    24. Peters E, van Elsas A, Heemskerk S et al. Alkaline phosphatase as a treatment of sepsis-associated acute kidney injury. J Pharmacol Exp Ther 2013; 344(1): 2-7. Go to original source... Go to PubMed...

    Return to the content


    Vnitřní lékařství

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.