Pathogenesis-oriented targets for adjunctive therapy

Otelo Rigato1, Eliezer Silva, Reinaldo Salomao

  • 1Immunology Laboratory, Division of Infectious Diseases, Universidade Federal de Sao Paulo, CEP 04039-032, Sao Paulo, SP, Brazil.

Insights

Despite effective antimicrobial treatments, sepsis mortality remains high. This review explores novel adjunctive sepsis therapies targeting the underlying pathophysiology, offering hope for improved patient survival rates.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pathophysiology

Background:

  • Sepsis outcomes are multifactorial, involving host and microbial factors.
  • Mortality persists despite adequate antimicrobial therapy, necessitating further research.
  • Recent advances in understanding sepsis pathophysiology offer new therapeutic avenues.

Purpose of the Study:

  • To review sepsis pathogenesis.
  • To identify potential targets for adjunctive sepsis therapies.
  • To comment on clinical trials and experimental data for these therapies.

Main Methods:

  • Literature review of published clinical trials.
  • Analysis of experimental data supporting adjunctive therapies.
  • Discussion of pathogenic-oriented therapeutic targets.

Main Results:

  • Adjunctive sepsis therapies have not yet consistently improved survival rates.
  • Significant progress in understanding sepsis pathophysiology has been made.
  • Identified potential adjunctive therapies include fluid replacement, glucose control, corticosteroids, mechanical ventilation, and activated protein C.

Conclusions:

  • Despite challenges, new effective sepsis treatments are plausible.
  • Targeting sepsis pathophysiology offers promising avenues for adjunctive therapy.
  • Further research and clinical trials are warranted to validate novel interventions.

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