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Paramyxoviruses for Tumor-targeted Immunomodulation: Design and Evaluation Ex Vivo
Published on: January 7, 2019
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.
Abstract:
The outcome of patients with sepsis arises from multiple factors affecting both the host and the invading microorganisms. Even within the setting of adequate antimicrobial use, patients still die of sepsis. Thus, strategies focusing on further therapy targets are an important area of interest for basic and clinical research. Although such adjunctive sepsis therapy has failed to achieve consistent better survival rates so far, the progress in understanding of the pathophysiology of sepsis seen in recent years is so profound, that the possibility that a new and effective treatment may arise should be warmly considered. Indeed, it may be considered that efficacious interventions, such as early and vigorous fluid replacement, strict blood glucose control, low-dose corticosteroid reposition, protective mechanical ventilation and activated-protein C are pathogenic-oriented targets of therapy. In this paper we aim to review some aspects of the pathogenesis of sepsis, focusing on possible targets for adjunctive therapy. Published clinical trials and experimental data supporting such trials are commented on.
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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