Cavaillon Jean-Marc, Singer Mervyn, Skirecki Tomasz
Experimental Neuropathology Unit, Institut Pasteur, Paris, France.
Bloomsbury Institute of Intensive Care Medicine, University College London, London, UK.
EMBO Mol Med. 2020 Apr 7;12(4):e10128. doi: 10.15252/emmm.201810128. Epub 2020 Mar 16.
Sepsis has been identified by the World Health Organization (WHO) as a global health priority. There has been a tremendous effort to decipher underlying mechanisms responsible for organ failure and death, and to develop new treatments. Despite saving thousands of animals over the last three decades in multiple preclinical studies, no new effective drug has emerged that has clearly improved patient outcomes. In the present review, we analyze the reasons for this failure, focusing on the inclusion of inappropriate patients and the use of irrelevant animal models. We advocate against repeating the same mistakes and propose changes to the research paradigm. We discuss the long-term consequences of surviving sepsis and, finally, list some putative approaches-both old and new-that could help save lives and improve survivorship.
世界卫生组织(WHO)已将脓毒症确定为全球卫生重点问题。人们付出了巨大努力来解读导致器官衰竭和死亡的潜在机制,并研发新的治疗方法。尽管在过去三十年的多项临床前研究中挽救了数千只动物,但尚未出现能明显改善患者预后的新的有效药物。在本综述中,我们分析了这种失败的原因,重点关注纳入了不恰当的患者以及使用了不相关的动物模型。我们主张避免重复同样的错误,并提出研究范式的变革。我们讨论了脓毒症幸存者的长期后果,最后列出了一些可能有助于挽救生命和提高生存率的新旧方法。