Toward Resolving the Challenges of Sepsis Diagnosis

Abstract

Sepsis in the UnitedStates has an estimated annual healthcare cost of $16.7 billion and leads to 120 000 deaths. Insufficient development in both medical diagnosis and treatment of sepsis has led to continued growth in reported cases of sepsis over the past two decades with little improvement in mortality statistics. Efforts over the last decade to improve diagnosis have unsuccessfully sought to identify a "magic bullet" proteic biomarker that provides high sensitivity and specificity for infectious inflammation. More recently, genetic methods have made tracking regulation of the genes responsible for these biomarkers possible, giving current research new direction in the search to understand how host immune response combats infection. Despite the breadth of research, inadequate treatment as a result of delayed diagnosis continues to affect approximately one fourth of septic patients. In this report we review past and present diagnostic methods for sepsis and their respective limitations, and discuss the requirements for more timely diagnosis as the next step in curtailing sepsis-related mortality. We also present a proposal toward revision of the current diagnostic paradigm to include real-time immune monitoring.

Potent Anti-inflammatory and Analgesic Actions of the Chloroform Extract of <i>Dendropanax morbifera</i> Mediated by the Nrf2/HO-1 Pathway

“…1,2) However, in chronic conditions, inflammation can lead to various diseases including inflammatory disorders, autoimmune diseases, inflammatory bowel disease, arthritis, lupus erythmatosus, endotoxin-induced organ failure, and malignancy. [3][4][5] Control of excessive inflammation has gained a continuous attention, but the currently available drugs for treating chronic inflammatory conditions produce serious side effects; therefore, finding equally effective but less toxic agents is a current challenge in scientific research. During the process of inflammation, a wide variety of pro-inflammatory cytokines including, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-12 and interferon (IFN)-γ, are released and these cytokines up regulate the production of reactive nitrogen species and prostaglandins via the activity of inducible nitric oxide synthase (iNOS) and cyclooxygenase-II (COX-II), respectively.…”

Multiplexed Immunoassays

“…[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63] Cytokines, chemokines, and growth factors are cell signaling proteins that mediate a wide range of physiological responses including immunity, inflammation, and hematopoiesis. Changes in the levels of these biomarkers are associated with a spectrum of diseases ranging from tumor growth, to infections, to Parkinson's disease.…”

Development of a Model-Based Clinical Sepsis Biomarker for Critically Ill Patients

“…In addition, a landmark clinical trial implementing a blood glucose control protocol resulted in a reduction in the incidence of sepsis (Van den Berghe et al, 2001). Currently available biomarkers, such as procalcitonin (PCT), provide sepsis diagnostic test results in 2-3 hours with commercially available kits, but to various levels of clinical accuracy (Carrigan et al, 2004).…”