Seminars in Respiratory and Critical Care Medicine,
Journal Year:
2024,
Volume and Issue:
45(04), P. 516 - 522
Published: July 8, 2024
Abstract
Sepsis
pathobiology
is
complex.
Heterogeneity
refers
to
the
clinical
and
biological
variation
within
sepsis
cohorts.
subtypes
refer
subpopulations
cohorts
derived
based
on
these
observable
variations
latent
features.
The
overarching
goal
of
such
endeavors
enable
precision
immunomodulation.
However,
we
are
yet
identify
immune
endotypes
achieve
this
goal.
subtyping
field
just
starting
take
shape.
current
in
literature
do
not
have
a
core
set
shared
features
between
studies.
Thus,
narrative
review,
reason
that
there
need
priori
state
purpose
minimum
would
be
required
immunomodulation
for
future
sepsis.
Critical Care,
Journal Year:
2024,
Volume and Issue:
28(1)
Published: July 13, 2024
Implementation
of
biomarkers
in
sepsis
and
septic
shock
emergency
situations,
remains
highly
challenging.
This
viewpoint
arose
from
a
public-private
3-day
workshop
aiming
to
facilitate
the
transition
into
clinical
practice.
The
authors
consist
international
academic
researchers
clinician-scientists
industry
experts
who
gathered
(i)
identify
current
obstacles
impeding
biomarker
research
sepsis,
(ii)
outline
important
milestones
critical
path
development
(iii)
discuss
novel
avenues
discovery
implementation.
To
define
more
appropriately
potential
place
better
understanding
pathophysiology
is
mandatory,
particular
patient's
trajectory
early
inflammatory
onset
late
persisting
immunosuppression
phase.
time-varying
host
response
urges
develop
time-resolved
test
characterize
persistence
immunological
dysfunctions.
Furthermore,
age-related
difference
has
be
considered
between
adult
paediatric
patients.
In
this
context,
numerous
barriers
adoption
practice,
such
as
lack
consensus
about
diagnostic
performances,
absence
strict
recommendations
for
development,
cost
resources
implications,
methodological
validation
challenges
or
limited
awareness
education
have
been
identified.
Biomarker-guided
interventions
patients
that
would
benefit
therapy,
sTREM-1-guided
Nangibotide
treatment
Adrenomedullin-guided
Enibarcimab
treatment,
appear
promising
but
require
further
evaluation.
Artificial
intelligence
also
great
field
through
capability
analyse
high
volume
complex
data
multiparametric
patient
endotypes
trajectories.
conclude,
requires
comprehensive
multidisciplinary
approach
employing
most
advanced
analytical
tools,
creation
platform
collaboratively
merges
scientific
commercial
needs
support
an
expedited
regulatory
approval
process.
BMJ,
Journal Year:
2025,
Volume and Issue:
unknown, P. e082583 - e082583
Published: Jan. 15, 2025
Abstract
Objective
To
evaluate
whether
the
immunomodulatory
drug
thymosin
α1
reduces
mortality
in
adults
with
sepsis.
Design
Multicentre,
double
blinded,
placebo
controlled
phase
3
trial.
Setting
22
centres
China,
September
2016
to
December
2020.
Participants
1106
aged
18-85
years
a
diagnosis
of
sepsis
according
sepsis-3
criteria
and
randomly
assigned
1:1
ratio
receive
(n=552)
or
(n=554).
A
stratified
block
method
was
used
for
randomisation,
participants
were
by
age
(<60
≥60
years)
centre.
Interventions
Subcutaneous
injection
every
12
hours
seven
days
unless
discontinued
owing
discharge
from
intensive
care
unit,
death,
withdrawal
consent.
Main
outcome
measure
The
primary
28
day
all
cause
after
randomisation.
All
analyses
based
on
modified
intention-to-treat
set,
including
who
received
at
least
one
dose
study
drug.
Results
Of
enrolled
study,
1089
included
(thymosin
group
n=542,
n=547).
occurred
127
(23.4%)
132
(24.1%)
(hazard
0.99,
95%
confidence
interval
0.77
1.27;
P=0.93
log-rank
test).
No
secondary
safety
differed
statistically
significantly
between
two
groups.
prespecified
subgroup
analysis
showed
potential
differential
effect
years:
hazard
1.67,
1.04
2.67;
0.81,
0.61
1.09;
P
interaction=0.01)
diabetes
(diabetes:
0.58,
0.35
0.99;
no
diabetes:
1.16,
0.87
1.53;
interaction=0.04).
Conclusions
This
trial
found
clear
evidence
suggest
that
decreases
Trial
registration
ClinicalTrials.gov
NCT02867267
.
Cell Communication and Signaling,
Journal Year:
2025,
Volume and Issue:
23(1)
Published: Feb. 14, 2025
Sepsis
remains
the
leading
cause
of
death
in
intensive
care
units.
Despite
newer
antimicrobial
and
supportive
therapies,
specific
treatments
are
still
lacking.
Neutrophils
pivotal
components
effector
phase
host
immune
defense
against
pathogens
play
a
crucial
role
control
infections
under
normal
circumstances.
In
addition
to
its
anti-infective
effects,
dysregulation
overactivation
neutrophils
may
lead
severe
inflammation
or
tissue
damage
potential
mechanisms
for
poor
prognosis
sepsis.
This
review
focuses
on
recent
advancements
understanding
functional
status
across
various
pathological
stages
sepsis
explore
by
which
participate
progression
provide
insights
treatment
targeting
neutrophils.
The Lancet Child & Adolescent Health,
Journal Year:
2024,
Volume and Issue:
8(9), P. 682 - 694
Published: Aug. 12, 2024
Sepsis
disproportionally
affects
children
across
all
health-care
settings
and
is
one
of
the
leading
causes
morbidity
mortality
in
neonatal
paediatric
age
groups.
As
shown
first
paper
this
Series,
age-specific
incidence
sepsis
highest
during
years
life,
before
approaching
adult
rates
adolescence.
In
second
we
focus
on
unique
susceptibility
patients
to
how
underlying
dysregulated
host
response
relates
developmental
aspects
children's
immune
system,
genetic,
perinatal,
environmental
factors,
comorbidities
socioeconomic
determinants
health,
which
often
differ
between
adults.
State-of-the-art
clinical
management
organised
around
three
treatment
pillars-diagnosis,
early
resuscitation,
titration
advanced
care-and
examine
available
guidelines
limitations
their
supporting
evidence.
Serious
evidence
gaps
remain
key
areas
care,
especially
surrounding
recognition,
common
interventions,
survivor
support,
end
offer
a
research
roadmap
for
next
decade
that
could
accelerate
targeted
diagnostics
personalised
use
immunomodulation.
However,
improving
outcomes
with
relies
fundamentally
systematic
quality
improvement
both
recognition
treatment,
theme
third
Series.
Digital
as
fourth
final
holds
promising
potential
breaking
down
barriers
hinder
progress
care
and,
ultimately,
global
child
health.
Nature Communications,
Journal Year:
2024,
Volume and Issue:
15(1)
Published: Oct. 19, 2024
Fluid
management
remains
a
critical
challenge
in
the
treatment
of
septic
shock,
with
individualized
approaches
lacking.
This
study
aims
to
develop
statistical
model
based
on
transcriptomics
identify
subgroups
shock
patients
varied
responses
fluid
strategy.
The
encompasses
494
patients.
A
benefit
score
is
derived
from
transcriptome
space,
higher
values
indicating
greater
benefits
restrictive
Adherence
recommended
strategy
associated
hazard
ratio
0.82
(95%
confidence
interval:
0.64–0.92).
When
applied
baseline
hospital
mortality
rate
16%,
adherence
could
potentially
lower
this
13%.
proteomic
signature
comprising
six
proteins
developed
predict
score,
yielding
an
area
under
curve
0.802
0.752–0.846)
classifying
who
may
In
work,
we
potential
utility
guiding
for
lacks
personalized
approaches,
which
are
improving
patient
outcomes.
Here,
authors
show
that
can
help
strategy,
reducing
rates.
