The results of a study published by John A. Kellum, MD, Michael P. Pinsky, MD, Russell L. Delude, PhD, Derek C. Angus, MD, MPH, and others from the University of Pittsburgh School of Medicine in the August 13/27 issue of the Archives of Internal Medicine indicate that past interpretations of how the immune system responds to infection – interpretations on which many experimental treatments were based – were incorrect.
This first large-scale natural history study of sepsis found that not all patients with sepsis mount the same immune response, even when they look the same clinically. Their study tracked 1886 patients with community-acquired pneumonia presenting at 28 US hospital emergency departments. The pneumonia led to severe sepsis in 583 patients; 149 of these patients died.
Sepsis is the 10th leading cause of death. While incidence rates of sepsis have been steadily increasing over the years, little is known about the condition. Past investigational treatments have been based on data from small studies, and most of these therapies have failed.
The researchers believe that these treatments failed, at least in part, because of insufficient data to fully understand the complexity and variability of the inflammatory response to sepsis. To gain a better understanding into the mechanisms behind the condition, the researchers conducted the Genetic and Inflammatory Markers of Sepsis study (GenIMS), which collected extensive clinical and laboratory data geared to help analyze the risks of a person developing sepsis and dying.
“With sepsis, we’re dealing with one of the deadliest diseases, yet we know so little about the condition. The situation is similar to what this country experienced over 50 years ago with heart disease and stroke – we knew that too many people were dying of cardiovascular disease, but we didn’t know enough about the disease to effectively treat and prevent it,” said McGowan Institute faculty member Dr. Angus, professor and vice chair of research, department of critical care medicine, University of Pittsburgh School of Medicine. “In response, the National Institutes of Health embarked on the Framingham Heart Study, the results of which have influenced everything we know about the prevention and treatment of cardiovascular disease. With our study, we’re hoping to do the same for sepsis, providing a greater understanding of the disease on which future treatment and prevention strategies can be based.”
Illustration: Crystal structure to human Interleukin-10. – Wikipedia.
UPMC News Bureau (08/13/07)
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MedPage Today (08/13/07)
Pittsburgh Tribune Review (08/14/07)
Archives of Internal Medicine (Abstract)