Division of Surgical Research, Department of Surgery, Brown University, Rhode Island Hospital, Providence, RI, USA.
Expert Opin Ther Targets. 2021 Mar;25(3):175-189. doi: 10.1080/14728222.2021.1897107. Epub 2021 Apr 12.
Sepsis is characterized by a dysregulated host response to infection. Sepsis-associated morbidity/mortality demands concerted research efforts toward therapeutic interventions which are reliable, broadly effective, and etiologically based. More intensive and extensive investigations on alterations in cellular signaling pathways, gene targeting as a means of modifying the characteristic hyper and/or hypo-immune responses, prevention through optimization of the microbiome, and the molecular pathways underlying the septic immune response could improve outcomes.] : The authors discuss key experimental mammalian models and clinical trials. They provide an evaluation of evolving therapeutics in sepsis and how they have built upon past and current treatments. Relevant literature was derived from a PubMed search spanning 1987-2020.: Given the complex nature of sepsis and the elicited immune response, it is not surprising that a single cure-all therapeutic intervention, which is capable of effectively and reliably improving patient outcomes has failed to emerge. Innovative approaches seek to address not only the disease process but modify underlying patient factors. A true improvement in sepsis-associated morbidity/mortality will require a combination of unique therapeutic modalities.
败血症的特征是宿主对感染的失调反应。败血症相关的发病率/死亡率需要协同进行研究努力,以寻找可靠、广泛有效的、基于病因的治疗干预措施。更深入和广泛地研究细胞信号通路的改变、作为改变特征性过强和/或过弱免疫反应的方法的基因靶向、通过优化微生物组进行预防,以及败血症免疫反应的分子途径,都可以改善预后。作者讨论了关键的实验性哺乳动物模型和临床试验。他们评估了败血症中不断发展的治疗方法,以及它们如何建立在过去和当前治疗方法的基础上。相关文献来源于 1987 年至 2020 年期间的 PubMed 搜索。鉴于败血症和引发的免疫反应的复杂性,单一的万能治疗干预措施,能够有效地、可靠地改善患者预后,但未能出现,这并不奇怪。创新方法不仅寻求解决疾病过程,而且还试图改变潜在的患者因素。败血症相关发病率/死亡率的真正改善需要多种独特的治疗方式相结合。