Abstract
Sepsis is a common clinical problem that is responsible for an increasing number of deaths. Many new therapies for severe sepsis have been developed but few have shown benefit in rigorous clinical trials. To date the most successful therapies are relatively simple clinical interventions: appropriate broad spectrum antibiotics; early goal directed therapies to restore tissue oxygen delivery; physiological dose hydrocortisone in patients with relative adrenal insufficiency; intensive insulin therapy to maintain normoglycemia; and lung-protective ventilation strategies. The only adjunctive therapy supported by strong evidence of benefit is Activated Protein C. Experimental therapies are being developed with improved in vitro and animal models and better understanding of the pathophysiology of sepsis in humans. Neutralization of the triggers of inflammation, such as endotoxin, and inhibition of the signal transduction mechanisms are promising new strategies. Statins may be beneficial in prevention of sepsis and as adjunctive treatments. Reconstitution of the immune response with interferon-gamma or granulocyte-macrophage colony stimulating factor may reverse immunoparesis in severe sepsis. Many other molecular targets have been identified for possible therapeutic intervention, but there are still fundamental difficulties to be overcome in demonstrating efficacy in clinical trials.
Current Topics in Medicinal Chemistry
Title: New Therapies for Sepsis
Volume: 8 Issue: 7
Author(s): Aubrey Cunnington and Simon Nadel
Affiliation:
Abstract: Sepsis is a common clinical problem that is responsible for an increasing number of deaths. Many new therapies for severe sepsis have been developed but few have shown benefit in rigorous clinical trials. To date the most successful therapies are relatively simple clinical interventions: appropriate broad spectrum antibiotics; early goal directed therapies to restore tissue oxygen delivery; physiological dose hydrocortisone in patients with relative adrenal insufficiency; intensive insulin therapy to maintain normoglycemia; and lung-protective ventilation strategies. The only adjunctive therapy supported by strong evidence of benefit is Activated Protein C. Experimental therapies are being developed with improved in vitro and animal models and better understanding of the pathophysiology of sepsis in humans. Neutralization of the triggers of inflammation, such as endotoxin, and inhibition of the signal transduction mechanisms are promising new strategies. Statins may be beneficial in prevention of sepsis and as adjunctive treatments. Reconstitution of the immune response with interferon-gamma or granulocyte-macrophage colony stimulating factor may reverse immunoparesis in severe sepsis. Many other molecular targets have been identified for possible therapeutic intervention, but there are still fundamental difficulties to be overcome in demonstrating efficacy in clinical trials.
Export Options
About this article
Cite this article as:
Cunnington Aubrey and Nadel Simon, New Therapies for Sepsis, Current Topics in Medicinal Chemistry 2008; 8 (7) . https://dx.doi.org/10.2174/156802608783955601
DOI https://dx.doi.org/10.2174/156802608783955601 |
Print ISSN 1568-0266 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4294 |
Call for Papers in Thematic Issues
Adaptogens—History and Future Perspectives
Adaptogens are pharmacologically active compounds or plant extracts that are associated with the ability to enhance the body’s stability against stress. The intake of adaptogens is associated not only with a better ability to adapt to stress and maintain or normalise metabolic functions but also with better mental and physical ...read more
AlphaFold in Medicinal Chemistry: Opportunities and Challenges
AlphaFold, a groundbreaking AI tool for protein structure prediction, is revolutionizing drug discovery. Its near-atomic accuracy unlocks new avenues for designing targeted drugs and performing efficient virtual screening. However, AlphaFold's static predictions lack the dynamic nature of proteins, crucial for understanding drug action. This is especially true for multi-domain proteins, ...read more
Challenges, Consequences and Possible Treatments of Anticancer Drug Discovery ll
The use of several compounds has been the subject of increasing interest in phytochemistry, biochemistry, and other fields of research at the chemistry-biology-ecosystems interface. In spite of the continued search for new anticancer drugs, cancer remains a leading cause of death. Cancer mortalities are expected to increase to 12.9 million, ...read more
Chronic Kidney Disease
The scope of the special thematic issue includes but not limited to the mechanism of chronic kidney disease (CKD), the treatment of renal fibrosis and early diagnosis of CKD and so on. We also welcome manuscripts from other scientific research area with respect to internal medicine. Cell death has been ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Fibromyalgia
Current Rheumatology Reviews Chemistry and Structural Evaluation of Different Phospholipase A2 Inhibitors in Arachidonic Acid Pathway Mediated Inflammation and Snake Venom Toxicity
Current Topics in Medicinal Chemistry Monoclonal Antibodies in the Treatment of Multiple Sclerosis
Current Medicinal Chemistry Clinical Application of Ghrelin
Current Pharmaceutical Design Potential Therapeutic Benefits of Dipyridamole in COVID-19 Patients
Current Pharmaceutical Design Overlooked Issues of Snakebite Management: Time for Strategic Approach
Current Topics in Medicinal Chemistry Production Technology and Functionality of Bioactive Peptides
Current Pharmaceutical Design Radiolabelled Regulatory Peptides for Imaging and Therapy
Anti-Cancer Agents in Medicinal Chemistry Pregnancy in Women on Dialysis: Success Stories from a Tertiary Care Hospital in Dubai, United Arab Emirates
New Emirates Medical Journal Malformations of the Female Genital Tract and Embryological Bases
Current Women`s Health Reviews Mineralocorticoid Antagonists in ESRD: An Overview of Clinical Trial Evidence
Current Vascular Pharmacology Treatment Possibilities for Psychosis in Parkinson's Disease with An Emphasis on the Newly Approved Drug: Pimavanserin
CNS & Neurological Disorders - Drug Targets Combinations of Renin-Angiotensin-Aldosterone System Antagonists:True Advantages?
Current Pharmaceutical Design Treatment Strategies for Multiple Myeloma in the Age of Novel Therapies
Current Cancer Therapy Reviews Ventilatory Support in Persistent Pulmonary Hypertension of the Newborn
Current Respiratory Medicine Reviews A Discussion of Natural Rubber Latex Allergy with Special Reference to Children: Clinical Considerations
Current Drug Targets - Immune, Endocrine & Metabolic Disorders A Prospective Observational Pilot Study of Adverse Drug Reactions in Patients Admitted in the Geriatric Ward of a Tertiary Hospital in North India
Current Pharmacogenomics and Personalized Medicine Urotensin II: A Vascular Mediator in Health and Disease
Current Vascular Pharmacology Induction and Amelioration of Environmental Stress in Isolated Islets Until Transplantation
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Innovative Cancer Treatments that Augment Radiotherapy or Chemotherapy by the Use of Immunotherapy or Gene Therapy
Recent Patents on Anti-Cancer Drug Discovery