Treating A Killer More Dangerous Than Cancer
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. The precipitation of sepsis as the result of Cytokine Storm Syndrome is common. In January of 2020, a report entitled; “Global, Regional, and National Sepsis Incidence and Mortality, 1990-2017: Analysis for the Global Burden of Disease Study,” was published in the Journal Lancet. The publication reported 48.9 million cases of sepsis and 11 million deaths in 2017. In that same year, an estimated 20.3 million sepsis cases and 2.9 million deaths were among children younger than 5-years old. The report referenced that sepsis kills more people around the world than all forms of cancer combined. In the United States, sepsis was reported to be the most common cause of in-hospital deaths with annual costs exceeding $24 billion.
Sepsis Risk Factors Linked to COVID-19
Sepsis is also a significant risk factor in virulent virus infections, including COVID-19. In March of 2020, the Journal Lancet published the first and largest study (at the time) of risk factors linked to COVID-19 infection and death in hospitalized adults who either died or were released from two hospitals in the Wuhan, China region. In the 191-patient analysis, 137 (72%) patients recovered from COVID-19 infection and were released, while 54 (28%) died during their hospital care. The study reported the diagnosis of sepsis in all 54 (100%) patients who died.
To date, more than 100 human studies have been conducted to evaluate the safety and benefit of candidate drugs to treat sepsis. With one brief exception (Xigris, Eli Lilly), none of these studies resulted in a market approved therapy. As the treatment of sepsis remains elusive for therapeutic drug agents, an increased understanding of the complex mechanisms that underlie sepsis support the potential of therapeutic strategies that modulate a broad-spectrum of inflammatory factors.
The Potential of Extracorporeal Blood Purification
As a result of failed drug studiesan increased focus has been directed toward extracorporeal blood purification, with an emphasis on devices that improve immune homeostasis through the depletion of circulating inflammatory mediators. Given the pivotal role of endotoxin and cytokine production in sepsis, it is anticipated that the simultaneous depletion of these inflammatory factors may establish the basis for an efficacious strategy. We also believe that inflammatory cargos being transported by circulating CytoVesicles represent a novel yet important therapeutic target.