The beginning of personalized medicine in sepsis: small steps to a bright future

Authors

  • E. Christaki,

    Corresponding author
    1. First Department of Internal Medicine, AHEPA University Hospital, Thessaloniki, Greece
    2. Infectious Diseases Division, Alpert School of Medicine of Brown University, Providence, RI, USA
    • Corresponding author: Eirini Christaki, MD, PhD, First Department of Internal Medicine, AHEPA University Hospital, St. Kiriakidi 1, Thessaloniki, Greece.

      Tel: +30 6973579927;

      fax: +30 2310993271;

      email: eirini.christaki@gmail.com

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  • E.J. Giamarellos-Bourboulis

    1. 4th Department of Internal Medicine, University of Athens Medical School, Athens, Greece
    2. Center for Sepsis Control and Care, Jena University Hospital, Jena, Germany
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  • The authors have no conflict of interest to declare.

Abstract

There is a growing recognition that there is a need for a more personalized approach towards sepsis care. In most clinical trials investigating novel therapeutic interventions against sepsis, patients have been considered a rather homogeneous population. However, there is probably more individual variability between septic patients than previously considered. The pathophysiology of sepsis is a complex and dynamic process that originates from the host immune response to infection and varies according to the genetic predisposition, immune status and co-morbid conditions of the host, the type of pathogen and the site and extent of infection. Until now, efforts to stratify septic patients according to their immune profile were hampered by the lack of specific biomarkers. Recent advances in molecular medicine have made it possible to develop tools that will facilitate a faster and more precise diagnosis of infection. Individual variability between each patient's responses to infection can assist in tailoring therapeutic interventions to the individual's disease profile and monitoring treatment response. In this review, we describe those recent advances in genomics and theragnostics, which are slowly entering clinical practice and which will make possible a more personalized approach to each septic patient in the next decade.

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