Editorial: Novel targets and state of the art therapies in ARDS and sepsis DOI Creative Commons
Daniel O’Toole, Shahd Horie, Emma Murphy

et al.

Frontiers in Medicine, Journal Year: 2024, Volume and Issue: 11

Published: Nov. 5, 2024

Dear Frontiers in Medicine reader, Acute respiratory distress syndrome (ARDS) and sepsis remain leading causes of patient morbidity mortality the COVID-19 pandemic has highlighted continuing lack effective therapeutic options for these other related acute inflammatory conditions. Among problems facing ARDS researchers is that there currently no specific biomarker rapid diagnosis, adhering to Berlin consensus criteria [1] therefore necessitates methods are time consuming expensive, particularly context overloaded health care services. Recent hot topics subphenotyping patients, with clearly delineated hyper-and hypo-inflammatory versions being more widely recognized [2] emerging biomarkers outcome giving clinicians opportunity treat quite distinct disease variants approaches. There also still licensed medicine specifically targeting or [3], a critical gap clinician's arsenal individual organ symptom support remains mainstay [4].Recently, host novel medicinal approaches have been investigated address problems, such as advances development pharmacological agents, recombinant protein drugs cell gene therapies. Bioinformatics based clinical profiling patients paving way stratification, targeted therapies precision medicines. Here, we summarise breaking contributions field collection articles published part Research Topic entitled "Novel Targets State Art Therapies Sepsis".Our first review paper explores utility measuring mitochondrial markers (McClintock et al, 2022). The summarized studies include assessments DNA blood, peroxidation range metabolites glucose, lactate xanthine point future where simple devices could instantly diagnose severity on minimal essential parameters. In sample analysis study, Peng colleagues identified dysfunctional iron metabolism mediated via hepcidin predictor (Peng 2022), finding which ultimately be applicable any aetiology. Finally this group manuscripts study immune subpopulations it was discovered ratio CD4/CD8 an assist directing resources appropriate sufferers (Pascual-Dapena 2022).Our second thematic grouping papers deep dive into pathology pathobiology ARDS. Indeed, argued topic overlaps informs diagnostics therapeutics fundamental intelligent approach care. As well alveolar cells lung, lung injury associated endothelial dysfunction vascular thrombosis provided comprehensive overview how Kallikrein-Kinin axis contributes process (Bailey 2023). Large datasets demand increasingly complex computational maximize meaningful information extracted, so happy welcome from Parkinson machine learning assisted mRNA one vulnerable populations, neonatal (Parkinson We see single-cell assessment risk factors progression shock importance chromatin accessibility near locus, CALCRL (Armstead 2023), To round off section, two focusing mechanisms their involvement sepsis. Firstly, Liu al. elucidates contribution ferroptosis pathway ischemia/reperfusion driven inflammation rat model (Liu 2023) secondly Hu coworkers intriguing detailing C-type lectin pancreatic stone multiple (MODS) (Hu 2023).In our final subsection explore management therapeutics, refining traditional protocols cutting edge advanced products (ATMPs). This theme includes retrospective comparing saline Ringers solutions resuscitation (Isha followed preclinical Gonzalez nebulizer delivered stem therapy (González novelty utilizing secretome opposed itself.We, editors special edition Medicine, hope you, find informative interesting did when assembling curating it, expect will spark research diagnosing treating devastating family diseases.Dr. Daniel O'Toole. Dr. Shahd Horie. Emma Murphy.

Language: Английский

Biomarkers in acute kidney injury DOI Creative Commons
Marlies Ostermann, Matthieu Legrand,

Melanie Meersch

et al.

Annals of Intensive Care, Journal Year: 2024, Volume and Issue: 14(1)

Published: Sept. 15, 2024

Language: Английский

Citations

19
Sepsis and Septic Shock DOI
Nuala J. Meyer, Hallie C. Prescott

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: 391(22), P. 2133 - 2146

Published: Dec. 4, 2024

Language: Английский

Citations

19
The 2024 Phoenix Sepsis Score Criteria: Part 5, What About “Parsimony” in the Criteria—Is Less Really More? DOI
Adrienne G. Randolph, Mark W. Hall, Niranjan Kissoon

et al.

Pediatric Critical Care Medicine, Journal Year: 2025, Volume and Issue: 26(2), P. e266 - e271

Published: Feb. 1, 2025

Language: Английский

Citations

5
Acute kidney injury DOI
Marlies Ostermann, Nuttha Lumlertgul, Rachel Jeong

et al.

The Lancet, Journal Year: 2025, Volume and Issue: 405(10474), P. 241 - 256

Published: Jan. 1, 2025

Language: Английский

Citations

4
Recent Advances of Precision Immunotherapy in Sepsis DOI Creative Commons

Antonios Arapis,

Dimitrios Panagiotopoulos,

Evangelos J. Giamarellos‐Bourboulis

et al.

Burns & Trauma, Journal Year: 2025, Volume and Issue: 13

Published: Jan. 1, 2025

Abstract Precision immunotherapy signifies the administration of required type immune intervention tailored to state activation at appropriate time window. The classification patients into different states is usually done by either a protein blood biomarker or molecular endotype that diagnostic precise state. Evidence coming from trials last decade suggests interventions should be split strategies aiming attenuate exaggerated responses, restore sepsis-induced immunoparalysis (SII) and vascular tone. Suggested responses are anakinra, nangibotide tocilizumab. Biomarkers guide their use ferritin, soluble triggering receptor expressed on myeloid cells-1 C-reactive protein. SII nivolumab, recombinant human interferon-gamma, CYT107, granulocyte macrophage colony stimulating factor IgM-enriched immunoglobulin prepapations. expression leukocyte antigen DR monocytes, absolute lymphocyte count levels M. One recently suggested strategy tone adrecizumab, which guided bio-adrenomedulin. these precision treatment still hampered need for large-scale randomized controlled trials.

Language: Английский

Citations

1
An international observational study validating gene-expression sepsis immune subgroups DOI Creative Commons
David Antcliffe, Estelle Peronnet, Frédéric Pène

et al.

Critical Care, Journal Year: 2025, Volume and Issue: 29(1)

Published: March 3, 2025

Sepsis gene-expression sub-phenotypes with prognostic and theranostic potential have been discovered. These identified retrospectively not translated to methods that could be deployed at the bedside. We aimed identify subgroups of septic patients high-risk poor outcome, using a rapid, multiplex RNA-based test. Adults sepsis, in intensive care unit (ICU) were recruited from 17 sites United Kingdom, Sweden France. Blood was collected days 2-5 (S1), 6-8 (S2) 13-15 (S3) after ICU admission analyzed centrally. Patients assigned into 'high' 'low' risk groups two models previously developed for Immune-Profiling Panel prototype on bioMérieux FilmArray® system. 357 (March 2021-November 2022). 69% male median age 67 years, APACHE II score 21 30% 90-day mortality rate. The proportions decreased over three sampling times (model 1: 53%, 40%, 15% model 2: 81%, 74%, 37%). In 1, higher group each time (S1: 35% vs 24%, p = 0.04; S2: 43% 20%, < 0.001; S3: 52% 0.007). 2, only significantly different second 27%, 0.77; 34% 14%, 0.002; 23%, 0.13). Gene-expression diagnostics can sepsis outcomes used precision medicine trials. ISRCTN11364482 Registered 24th September 2020.

Language: Английский

Citations

1
A common longitudinal intensive care unit data format (CLIF) for critical illness research DOI
J.C. Rojas, Patrick G. Lyons, K. Chhikara

et al.

Intensive Care Medicine, Journal Year: 2025, Volume and Issue: unknown

Published: March 13, 2025

Language: Английский

Citations

1
A Patient-Level Meta-Analysis of Intensive Glucose Control in Critically Ill Adults DOI
Derick Adigbli, Yang Li, Naomi Hammond

et al.

NEJM Evidence, Journal Year: 2024, Volume and Issue: 3(8)

Published: June 12, 2024

BackgroundWhether intensive glucose control reduces mortality in critically ill patients remains uncertain. Patient-level meta-analyses can provide more precise estimates of treatment effects than are currently available.MethodsWe pooled individual patient data from randomized trials investigating adults. The primary outcome was in-hospital mortality. Secondary outcomes included survival to 90 days and time live cessation with vasopressors or inotropes, mechanical ventilation, newly commenced renal replacement. Severe hypoglycemia a safety outcome.ResultsOf 38 eligible (n=29,537 participants), 20 (n=14,171 participants) provided including status for 7059 7049 participants allocated conventional control, respectively. Of these 1930 (27.3%) 1891 (26.8%) individuals assigned respectively, died (risk ratio, 1.02; 95% confidence interval [CI], 0.96 1.07; P=0.52; moderate certainty). There no apparent heterogeneity effect on any examined subgroups. Intensive increased the risk severe 3.38; CI, 2.99 3.83; P<0.0001).ConclusionsIntensive not associated reduced but hypoglycemia. We did identify subgroup whom beneficial. (Funded by Australian National Health Medical Research Council others; PROSPERO number CRD42021278869.)

Language: Английский

Citations

6
Aiming for precision: personalized medicine through sepsis subtyping DOI Creative Commons

Aryna Kolodyazhna,

W. Joost Wiersinga, Tom van der Poll

et al.

Burns & Trauma, Journal Year: 2025, Volume and Issue: 13

Published: Jan. 1, 2025

Abstract According to the latest definition, sepsis is characterized by life-threatening organ dysfunction caused a dysregulated host response an infection. However, this definition fails grasp heterogeneous nature and underlying dynamic pathophysiology of syndrome. In heterogeneity, efforts have been made stratify patients into subtypes, either based on their clinical presentation or pathophysiological characteristics. Subtyping introduces possibility implementation personalized medicine, whereby each patient receives treatment tailored individual disease manifestation. This review explores currently known categorized subphenotypes endotypes, as well treatments that researched thus far in context subtypes medicine.

Language: Английский

Citations

0
Haemodynamic management of septic shock DOI Creative Commons
Yuki Kotani,

Nicholas Ryan,

Andrew Udy

et al.

Burns & Trauma, Journal Year: 2025, Volume and Issue: 13

Published: Jan. 1, 2025

Abstract Septic shock is a significant challenge in the management of patients with burns and traumatic injuries when complicated by infection, necessitating prompt effective haemodynamic support. This review provides comprehensive overview current strategies for vasopressor fluid septic shock, aim to optimize patient outcomes. With regard management, we elaborate on pharmacologic profiles clinical applications catecholamines, vasopressin derivatives, angiotensin II, other vasoactive agents. Noradrenaline remains central management. The addition vasopressin, sequentially added noradrenaline, offers non-catecholaminergic effect some benefits risks adverse effects. Emerging agents such as II hydroxocobalamin are highlighted their roles catecholamine-resistant vasodilatory shock. Next, crystalloids currently preferred initial resuscitation, balanced showing over saline. application albumin warrants further research. High-quality evidence does not support large-volume an individualized strategy based parameters, including lactate clearance capillary refill time, recommended. existing knowledge suggests that early initiation, particularly may be critical cases where resuscitation takes inadequate effect. Management refractory challenging, novel like methylene blue potential recent studies. In conclusion, Further research needed developing usage approaches.

Language: Английский

Citations

0