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Study begins to reveal clues to the cause and progression of sepsis
Date:8/13/2007

aid Derek C. Angus, M.D., M.P.H., professor and vice chair of research, department of critical care medicine, University of Pittsburgh School of Medicine. In response, the National Institutes of Health embarked on the Framingham Heart Study, the results of which have influenced everything we know about the prevention and treatment of cardiovascular disease. With our study, were hoping to do the same for sepsis, providing a greater understanding of the disease on which future treatment and prevention strategies can be based.

For this analysis, researchers evaluated data from 1,886 of the study participants who were hospitalized with community-acquired pneumonia (CAP), the leading cause of severe sepsis. More than 30 percent of the subjects developed severe sepsis, of whom 26 percent died.

To determine the inflammatory response in the participants with CAP, the researchers measured cytokine levels daily for the first week of hospitalization and then weekly thereafter. They found that 82 percent of the participants with CAP had elevated cytokine levels. Levels were highest when the subject presented at the emergency room, tapered down over the first few days, but remained elevated throughout the first week of hospitalization even after the clinical signs of infection had subsided. Levels were highest in those with fatal severe sepsis, lowest in those with CAP but no sepsis.

Our data show that much of what we previously thought about the role the inflammatory response plays in sepsis was wrong or incomplete. We had thought the inflammatory response to infection was relatively short-lived, just a few days, and that it was similar in patients with similar clinical signs. Instead, we found that the inflammatory response was extremely variable across patientsmore than 50-fold differences were seen in some markers. Additionally, we found that the inflammatory response extends past the outward symptoms, far longer than previous data would suggest
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Contact: Jocelyn Uhl Duffy
UhlJH@upmc.edu
412-647-3555
University of Pittsburgh Schools of the Health Sciences
Source:Eurekalert

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