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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
PubMed

Insights

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.
Abstract

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