Deadly Sepsis: Are We Closer to Finding the Cause?
Sepsis, a toxic, inflammatory response to infection, afflicts 20–30 million patients globally each year, according to the Global Sepsis Alliance. It is estimated that worldwide one person dies from sepsis every few seconds.
In the U.S., another organization, the Sepsis Alliance, reports that approximately 258,000 Americans are diagnosed with sepsis yearly and that hospitals spend about $20 billion annually fighting the disease. About 40% of Americans diagnosed with severe sepsis die.
Severe sepsis leads to organ dysfunction, elevated liver enzymes, and altered cerebral function. Intensive care is usually the standard treatment for almost all sepsis victims. While sepsis usually results from disease or injury, many patients become septic following routine or elective surgery.
Because it is such a complex disorder, it has been extremely difficult to find effective treatments for sepsis. In the early 1990s, a high-flying biotech company, Centocor, developed what many thought would be THE standard therapy for sepsis. Unfortunately, their product, called Centoxin, failed miserably in clinical trials and the company’s stock fell by over two-thirds in one day. Subsequent efforts to treat sepsis have also been largely unsuccessful.
Now comes news from China that regulatory T cells (Tregs), a component of the immune system, appear to have an important role in suppressing the immune response in advance of sepsis.
In a review article in the Journal of Interferon & Cytokine Research, a peer-reviewed publication from Mary Ann Liebert, publishers, researchers say that by understanding this role new therapeutic strategies for improving patient outcomes may emerge.
The scientists review the growing body of literature supporting a link between alterations in Treg function and the development of sepsis, based on animal studies and preliminary human studies. In the article, “The Role of Regulatory T Cells in the Pathogenesis of Sepsis and Its Clinical Implication,” the authors suggest that accumulating experimental and clinical evidence indicates that manipulating Tregs may offer a promising strategy for treating patients with septic shock.
“Regulatory T cells are receiving much attention as important determinants of both beneficial and detrimental immune responses,” says co-editor-in-chief Thomas A. Hamilton, Ph.D., chairman, department of immunology, Cleveland Clinic Foundation. “This review brings focus to the function of this important cell population in the context of sepsis, a condition more frequently associated with innate immunity.”