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Can feeding the fire of an overcharged immune system save the lives of patients in septic shock?

Sepsis is a condition where a violent attack, called a “cytokine storm,” is released by the immune system on an infection.  Unfortunately, the immune attack often kills the patient, too.  In recent years, the Centers for Disease Control and Prevention (CDC) has initiated public health and clinical initiatives to educate the public about what sepsis looks like, and help clinicians recognize the condition before it is too late.

Research continues to try and identify exactly why the immune system of some people runs amok and triggers a deadly attack on the host body.  Standard treatment for sepsis is the use of antibiotics to take down the infection, and anti-inflammatory medications to reduce the virulent effect of the immune attack on body tissue and internal organs.

Despite sounding like the last thing you would want to do, researchers from the Washington University School of Medicine in St. Louis tried to boost the overactive immune system of sepsis patients—and had some success.  In a study published in the journal JCI insight, scientists created a drug that contains a protein to promote the growth and survival of two important types of immune cells that are frequently found in low numbers in sepsis patients.

In a press release, lead author Dr. Richard Hotchkiss notes, “Mortality rates from sepsis have remained essentially the same over the last 50 years.  Hundreds of drugs have been tried and have failed. It may sound counterintuitive when inflammation is such a problem early in sepsis, but our approach is to stimulate certain immune cells to help the patient’s system take control of the infection.”

A Small Clinical Trial Offers Some Hope

The study involved 27 patients between 33 and 82 years of age being treated at four academic hospitals in the US and France.  All of these patients were very ill and hospitalized with septic shock.  In the group, 17 patients were randomly assigned to receive the drug interleukin-7 (IL-7), the protein that supports growth and survival of specific immune cells, while 10 patients received standard treatment.

An unfortunate feature of septic shock is a drop in the number of white blood cells, or leukocytes, in the bloodstream.  This condition is called “leukopenia.” The condition is dangerous because white blood cells carry out a major role in defending the body from infectious germs.

In earlier mice studies, researchers found that animals that did not experience white blood cell die-off were more likely to survive sepsis. The drug IL-7 has been shown to cause an increase in two types of white blood cells called CD4 and CD8.  In its role as a “helper” cell, CD4 signals to “killer” CD8 immune cells which arrive on the scene to destroy the infectious agent.

In this study, the use of IL-7 did not worsen or induce a cytokine storm in the patients who received the drug.  In addition, the number of CD4 and CD8 cells of these patients multiplied by three to four times, boosting the ability of their immune systems to survive the sepsis attack.

Because a sepsis episode negatively impacts the function of the immune system, many patients suffer serious and lingering infections in the months following.  Researchers suggest that boosting the numbers of important white blood cells helps with the initial sepsis attack, and afterward.

This research addresses the immune dysfunction that is at the heart of a deadly sepsis attack.  By boosting the right immune cells, fewer people may die when their immune cells answer the wrong call.

Sepsis can be deadly, especially if misdiagnosed or missed entirely when a patient first presents at the hospital.  Know the symptoms of sepsis, and if you or a loved one have serious signs, and make sure to ask “could it be sepsis?” when you talk to a doctor or healthcare provider.

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