TUESDAY, Dec. 20 (HealthDay News) -- Severe sepsis can impair
the immune system, a new study says.
Sepsis causes more than 225,000 deaths annually in the United
States, the researchers said. "Developing new therapies for sepsis
has been particularly challenging, with more than 25 unsuccessful
drug trials," Jonathan S. Boomer, of the Washington University
School of Medicine, St. Louis, and colleagues wrote as background
information in the study. "Characterized by an initial intense
inflammatory response or 'cytokine storm,' patients with sepsis may
present with fever, shock, altered mental status, and organ
dysfunction," they said.
"Whether this hyperinflammatory phase is followed by immunosuppression is controversial. Animal studies suggest that multiple immune defects occur in sepsis, but data from humans remain conflicting," the researchers noted.
Sepsis is a severe, systemic bacterial infection occurring in
the body's blood system or tissues. It can be life-threatening, and
patients require rapid treatment with intravenous antibiotics.
For the new study, researchers analyzed lung and spleen tissue
from 40 intensive care unit patients, average age 72, who died with
active severe sepsis and compared them to spleen and lung samples
from a control group of 49 people, average age 53, who died without
sepsis.
The median (midpoint) number of days in the ICU for patients
with sepsis was 8, and the median duration of sepsis was 4
days.
Findings from biochemical tests and cell and tissue analyses for
patients who died of sepsis were consistent with immune
suppression, compared to the patients who did not have sepsis when
they died.
The study appears Dec. 21 in the
Journal of the American Medical Association.
With therapies improving, patients are more likely to survive
sepsis, the researchers suggested, but may still have impaired
immune systems, leaving them more susceptible to infections from
organisms that wouldn't affect healthier people.
"The present study has a number of important therapeutic implications. Most investigative agents in sepsis have been directed at blocking inflammation and immune activation. Although such therapies may be successful if applied early, they may be harmful if applied later in the immuno-suppressive phase," the researchers wrote in a journal news release.
"An important part of implementing more targeted therapies will be to accurately determine the immune status of individual patients during their disease," the researchers concluded.
More information
The U.S. National Institute of General Medical Sciences has more
about
sepsis.