[ad_1]
Sepsis is an infection that kills as many Americans each year as stroke and Alzheimer's disease – about 250,000 – but very little has changed in the treatment of this age-old plague. Now researchers at the Irving Medical Center of Columbia University have found a clue to understanding how an infection can turn into sepsis by weakening the body's immune response. This research can also help doctors identify patients who may need immediate intensive treatment to save their lives.
Sepsis can begin with a simple infected cut. When the immune system fails to fight the infection, sepsis occurs when inflammation spreads throughout the body, leaving patients vulnerable to organ damage, serious secondary infections and death. Time is running out, doctors lack fast and effective ways to diagnose this deadly disease
"The best treatment for sepsis begins with rapid detection, our results suggest that specific molecules called microRNAs may be potential biomarkers of poor prognosis, indicating "explains Sankar Ghosh, Ph.D., Ph.D., Ph.D., professor of microbiology and immunology to the Silverstein and Hutt family and chairman of the Department of Microbiology and Immunology of Columbia University of Vagelos College of Physicians and Surgeons (VP & S).
The immune system first initiates a vigorous attack against sepsis, but the innate immune response In a search to understand the underlying mechanism, Ghosh's team identified two microRNAs (miR-221 and miR-222) that are produced in immune cells during a period of time. These microRNAs reduce the expression of inflammatory genes and, in a mouse model of sepsis, suppress the immune system at a time when the body desperately needs a complete immune response.
Patients with suspected sepsis had a similar reaction. Of the 30 hospitalized patients, those with signs of organ failure have higher levels of miR-221 and miR-222 in their blood samples. In septic patients, those with miR-221 and high miR-222 also showed evidence of immunosuppression.
Both microRNAs could be the basis of a test to help physicians classify patients in organic deficiencies that present a high risk of sepsis. and death and patients with milder infections. With a faster diagnosis, doctors could start administering antibiotics and fluids to control the infection more quickly before patients succumb to failures and secondary infections
"When Doctors Face Sepsis in the hospital, They can choose to use the widest spectrum of antibiotics for an aggressive approach to cover all the bacterial causes of infection, but this can cause later resistance to antibiotics, a growing problem, "says Daniel Freedberg, co-author of the study, MD, an assistant professor of medicine at CUIMC. "Any test to identify the cause of sepsis to guide treatment options is invaluable."
Clinical trials will be needed to validate the utility of testing patients for these microRNAs as a quick guide to prognosis and treatment. The research comes at a time when the number of cases of sepsis per year has been rising in the United States, according to the National Institutes of Health. Creating better diagnoses can help reverse this trend and save lives.
The study, published June 27 in Nature, titled "Induction of Inborn Immune Memory by Micro RNA Targeting Chromatin Remodeling Factors."
was supported by NIH grants (R21 AI116082 and R37 AI33443)
Other authors are: John J. Seeley (CUIMC), Rebecca Baker (CUIMC), Ghait Mohamed (Jena University Hospital) , Jena, Germany), Tony Bruns (Jena University Hospital), Matthew S. Hayden (CUIMC, now at Dartmouth-Hitchcock Medical Center), and Sachin D. Deshmukh (Jena University Hospital).
Source: Columbia University Irving Medical Center
Source link
