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Endotoxemic Shock: A Molecular Phenotype in Sepsis
John A Kellum1,2, Debra Foster2, Paul M Walker2
1Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Nephron
|July 5, 2022
Summary
Sepsis subtypes exist, with endotoxin-associated sepsis showing distinct organ failure patterns and high mortality. Understanding these differences is crucial for effective sepsis treatment strategies.
Area of Science:
- Microbiology
- Immunology
- Critical Care Medicine
Background:
- Sepsis presents with significant patient heterogeneity in organ dysfunction.
- This variability suggests the existence of distinct sepsis subtypes.
- Identifying these subtypes is critical for optimizing patient treatment.
Purpose of the Study:
- To investigate the role of endotoxin as a potential sepsis subtype.
- To characterize the clinical and molecular features of endotoxin-associated sepsis.
Main Methods:
- A narrative review of scientific literature was conducted.
- The review focused on studies involving endotoxin from 1970 to 2022.
Main Results:
- Endotoxemia in humans is linked to a consistent pattern of organ failure: shock, endothelial dysfunction, acute kidney injury, and hepatic dysfunction.
- This pattern aligns with complement activation and uncontrolled inflammation.
- Artificial intelligence analysis independently identified a sepsis subtype with these specific organ failures.
Conclusions:
- Endotoxin represents a significant molecular phenotype within sepsis.
- This endotoxin-driven sepsis subtype exhibits unique clinical characteristics.
- Patients with this endotoxin phenotype face a high mortality risk.
