Sepsis: Personalized Medicine Utilizing ‘Omic’ Technologies—A Paradigm Shift?

Itenov, Theis Skovsgaard; Murray, Daniel D.; Jensen, Jens Ulrik Stæhr

doi:10.3390/healthcare6030111

Cited by 23 publications

(18 citation statements)

References 53 publications

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“…Knowledge on the heterogeneity of immune traits or a patient population could lead to personalized healthcare. As an example, omics technologies are currently being applied to develop treatment for sepsis patients targeting their precise immune state [75,76]. Precision medicine could be applied in the future utilizing trained immunity to prevent infectious diseases or to improve vaccine strategies.…”

Section: Host-pathogen Interaction Assessment Using Ex-vivo Stimulati...mentioning

confidence: 99%

Resolving trained immunity with systems biology

et al. 2021

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Trained immunity is characterized by long‐term functional reprogramming of innate immune cells following challenge with pathogens or microbial ligands during infection or vaccination. This cellular reprogramming leads to increased responsiveness upon restimulation, and is mediated through epigenetic and metabolic modifications. In this review, we describe how molecular mechanisms underlying trained immunity, for example, induced by β‐glucan or Bacille Calmette‐Guérin (BCG) vaccination, can be investigated by using and integrating different layers of information including genome, epigenome, transcriptome, proteome, metabolome, microbiome, immune cell phenotyping, and function. We also describe the most commonly used experimental and computational techniques. Finally, we provide a number of examples of how a systems biology approach was applied to study trained immunity to understand interindividual variation or the complex interplay between molecular layers. In conclusion, trained immunity represents an opportunity for regulating innate immune function, and understanding the complex interplay of mechanisms that mediate trained immunity might enable us to employ it as a clinical tool in the future.

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Section: Host-pathogen Interaction Assessment Using Ex-vivo Stimulati...mentioning

confidence: 99%

Resolving trained immunity with systems biology

et al. 2021

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“…In 2002, Ken Hillman anticipated a bigger role for the critical care physician outside the ICU. In the paper "Critical Care without Walls" 34 he foresaw the establishment of the fast response teams, offering rapid recognition and treatment to the critically ill patients at any ward of the hospital. Today, we are heading into an era of expanding the very limits of the hospitals.…”

Section: The Hospital Without Wallsmentioning

confidence: 99%

Artificial intelligence: what should an intensivist have in mind in the beginning of the new era?

Filho¹

2021

APIC

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A new era is coming for medicine, and for critical care in particular. The intensive care unit is at the edge of being completely changed by artificial intelligence, and many challenges are ahead of the intensive care physician. This article aims to address the benefits and difficulties that big data will bring to clinicians, and to provide an overview on the subject. Key words: Big Data; Artificial intelligence; ICU; Critical Care; Black box Citation: Filho LACB. Artificial intelligence: what should an intensivist have in mind in the beginning of the new era. Anaesth. Pain intensive care 2021;25(1):8-12. DOI: 10.35975/apic.v25i1.1428 Received: 10 December 2020, Reviewed: 3 January 2021, Accepted: 8 January 2021

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“…Sepsis 3.0 definition and diagnostic criteria 2 based on widely used laboratory findings, vital signs, and clinical intervention (qSOFA and SOFA scores), did not include novel biomarkers or microbiological results. 5 Adding bioinformatics and omics to sepsis diagnosis maybe a challenge, and their value for improving sepsis outcomes is still unclear. 6,7 Applied bioinformatics and omics in clinical practice of sepsis are also limited by financial conditions.…”

Section: Challengesmentioning

confidence: 99%

<p>SEPSIS. Educational and Best Practice Frontiers. Beyond the Boundaries of Fatality, Enhancing Clinical Skills and Precision Medicine</p>

Trovato¹

2020

TCRM

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Dissemination and exploitation of knowledge regarding affordable clinical skills and innovative precision medicine, two current topics in active development in medicine, may contribute to improve also sepsis management. Sepsis is a life-threatening organ dysfunction due to a dysregulated host response to infection. Sepsis is strongly related to all body organs or to systemic diseases and to the quality of the best-practice in use, which is particularly critical in surgical or intervention techniques. Trauma, surgical and mini-invasive procedures, vascular or endoscopic interventions, otolaryngology, obstetrics-gynecological and urological procedures, malnutrition, dental, skin, chronic liver, kidney and respiratory disease are frequently involved. Accordingly, apart from the clinical risk analysis and management of the process of care, the actual factors that may be easily neglected are the techniques used, the personal skills of the health professionals and the quality of the equipment. The quest for biomarkers consistent with the unmet needs of medical doctors and of their patient and the efforts for overcoming bacterial antibiotic resistances are currently the main foci of medical research. In addition, in this regard, research and innovation would benefit from greater knowledge, skills and use of bioinformatics and omics. The caveats related to in-silico approaches must be flagged: algorithms may equally warrant scientific innovations or hide the lack of them; a patient is more than a set of covariates. Epidemiology and prevention includes all the actions suitable for achieving an adequate hygiene and immunization of populations and for safer hospital policies and procedures during Patients' stays. In any subset, the most unresolved critical point in sepsis is a timely diagnosis. This is impaired by low degrees of suspicion for the possibility of emerging sepsis, by the shortage of use of the simplest microbiological testing but, equally or more, by the insufficient diffusion of non-invasive imaging skills suitable to detect and monitor the emerging sites and sources of infection. In primary care, in emergency facilities, in hospital wards and in intensive care units, inclusion of appropriate knowledge, skills, expertise and imaging equipment must be extended as much as possible. The low cost of UltraSound machines and of increasing bioinformatics literacy by e-learning, makes such investments affordable even in limited-resources contexts. Frontier educational and best practice intervention enhancing affordable clinical skills and innovative precision medicine may lead beyond the boundaries of fatal outcomes in sepsis.

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Sepsis: Personalized Medicine Utilizing ‘Omic’ Technologies—A Paradigm Shift?

Cited by 23 publications

References 53 publications

Resolving trained immunity with systems biology

Resolving trained immunity with systems biology

Artificial intelligence: what should an intensivist have in mind in the beginning of the new era?

<p>SEPSIS. Educational and Best Practice Frontiers. Beyond the Boundaries of Fatality, Enhancing Clinical Skills and Precision Medicine</p>

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