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Precision medicine in pediatric sepsis.
Mihir R Atreya1, Hector R Wong
1Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center.
Current Opinion in Pediatrics
|May 16, 2019
Summary
Precision medicine offers a new approach to treating pediatric sepsis by identifying patient subgroups likely to benefit from targeted therapies. This strategy aims to improve outcomes in severe pediatric infections.
Area of Science:
- Pediatric critical care medicine
- Translational research
- Bioinformatics and computational biology
Background:
- Pediatric sepsis is a complex condition with high mortality and limited treatment options.
- Previous immunomodulator trials in sepsis have lacked efficacy despite biological rationale.
- A precision medicine approach is needed to tailor interventions for pediatric sepsis.
Purpose of the Study:
- To explore the application of precision medicine in pediatric sepsis.
- To identify patient subgroups who may benefit from targeted therapeutic interventions.
- To enhance clinical trial design and patient selection for sepsis therapies.
Main Methods:
- Utilizing 'omics data' and bioinformatics to identify pediatric septic shock endotypes.
- Employing multibiomarker strategies for risk stratification at disease onset.
- Developing predictive and prognostic enrichment strategies for clinical trials.
Main Results:
- Identification of distinct molecular endotypes and biological pathways in pediatric septic shock.
- Development of methods to identify high-risk pediatric sepsis patients using biomarkers.
- Potential for optimizing patient selection in clinical trials through enrichment strategies.
Conclusions:
- Precision medicine can subclassify and risk-stratify pediatric sepsis patients for targeted therapies.
- Robust research, rigorous trials, and big data infrastructure are essential for precision sepsis medicine.
- A bedside-to-bench-to-bedside model can provide clinicians with decision-making tools for pediatric sepsis.
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