Strategies to treat sepsis: old and new

Author(s): Steven P LaRosa, Steven M Opal

Despite advances in critical care, the incidence and mortality from severe sepsis remains unacceptably high. Numerous strategies focusing on the pathophysiology of severe sepsis are being pursued. Bacteria and bacterial products that trigger sepsis are being targeted via antibodies, signaling antagonists and filtration columns. Excessive inflammation is being addressed with the use of specific blocking antibodies for injurious cytokines as well as devices and molecules that address the proinflammatory cytokine pathways. Injury to the gut and the endothelial lining that occur during sepsis and propagate inflammation and organ dysfunction is being addressed with protective molecules. Replacement strategies for protective molecules exhausted during the sepsis episode are being examined. Finally, strategies to reverse the immunosuppression of sepsis are being revived.