Better treatment of sepsis by understanding patients’ immune systems

20% of deaths worldwide are related to sepsis, which is the leading cause of death in intensive care.

We can only treat sepsis better if we better understand patients’ immune systems. Therefore, researchers should make greater use of artificial intelligence and omics techniques that can provide a more complete picture of the immune system. This was stated, among others, by researchers from the Radboud University Medical Center in a summary article published in The Lancet Respiratory Medicine.

20% of deaths worldwide are related to sepsis, the leading cause of death in intensive care. Sepsis is caused by a combination of three factors: an infection, organ failure, such as the kidneys or lungs, and a dysregulated immune system response. As a result, patients can get so sick that they end up in intensive care. About a third of patients die there.

There is no good treatment for sepsis yet, says researcher Matthijs Kox. “We have antibiotics to fight the infection, but apart from that we only have supportive therapies. We consider, for example, artificial respiration if the lungs no longer work properly, or kidney dialysis in case of kidney failure. But so far there is no drug that has been shown to be effective against sepsis.’

Kox and his colleagues focus their research on our immune system. Important according to Kox because we still know too little about the dysregulated immune response. «An infection and organ failure are quite easy to determine, but this does not apply to the state of the immune system. For us this is still largely a black box.’

Overreaction or paralysis
Two things can happen with sepsis: The immune system can work very hard, causing a violent overreaction that causes organs to fail. But it can also happen that the immune system becomes paralyzed and no longer does anything. Then the infection is not resolved and further infections often occur, for example from fungi that do not bother healthy people at all. These infections are often difficult to treat.

How can we better map the state of the immune system? This is the big question Kox and his colleagues are focusing on. He is trying to answer this question as part of the European EGIS partnership, which focuses on research on the immune system in sepsis. In a recent publication in The Lancet Respiratory Medicine, they discuss the value of various markers in the blood and call for further research using modern omics techniques. This allows you to get a broad picture of the immune system with the help of artificial intelligence.

Not even a form of sepsis
The authors of the article argue that for too long sepsis has been considered a homogeneous syndrome, everyone treated the same way. Kox: ‘Fortunately this idea is now outdated. Sepsis comes in many forms. It can be contracted from pneumonia, but also from a bladder infection or a simple wound to the foot. And immune system dysregulation is also a little different for everyone.’ He makes the comparison with cancer: ‘Oncologists don’t treat all tumors the same way. You approach bladder cancer differently than breast cancer. And there’s still a lot of variation within these cancer types. For this reason, oncologists first determine the characteristics of the tumor and on this basis the therapy is started.’

According to Kox, this is also the way things should be with sepsis. The aim of his research is to recognize faster and better the state in which the immune system is: is it working too hard or paralyzed, and why? “If we can determine this quickly in an acute ICU setting, doctors can better help patients. We have the medicine. We just don’t know yet who to give which drug and when.’

Source: Radboud University Medical Center

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2023-12-29 10:00:06
#treatment #sepsis #understanding #patients #immune #systems