Adjunctive therapy for septic shock: a review of experimental approaches.
Septic shock remains a major cause of morbidity and mortality, especially in the intensive care setting. A vast array of treatment strategies is under investigation; despite success in animal models, no effective adjunctive therapy has yet been approved for clinical use. This paper reviews the development of experimental therapies for sepsis and discusses those treatments that show promise for application in humans. Approaches to treatment fall into three broad categories: strategies directed against bacterial components, those directed against host-derived inflammatory mediators, and those designed to limit tissue damage. Because septic shock is a dynamic and evolving condition, different strategies may be needed at different stages in the pathogenesis of sepsis. Through carefully performed trials and thoughtful selection of combination therapy aimed at different points in the pathological process, it may be possible in the future to modify the course of this serious condition.
Lynn
W A
WA
Department of Infectious Diseases and Bacteriology, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom.
Cohen
J
J
D000209:Acute-Phase Proteins; D000818:Animals; D000907:Antibodies, Bacterial / Q000627:therapeutic use; D016470:Bacteremia / Q000628:therapy; D002352:Carrier Proteins / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016207:Cytokines / Q000037:antagonists & inhibitors; D004731:Endotoxins / Q000037:antagonists & inhibitors; D006801:Humans; D008050:Lipid A / Q000031:analogs & derivatives / Q000627:therapeutic use; D008070:Lipopolysaccharides / Q000037:antagonists & inhibitors; D008562:Membrane Glycoproteins; D012772:Shock, Septic / Q000628:therapy*; D000099231:Lipopolysaccharide-Binding Protein
D000209:Acute-Phase Proteins; D000907:Antibodies, Bacterial; D002352:Carrier Proteins; D016207:Cytokines; D004731:Endotoxins; D008050:Lipid A; D008070:Lipopolysaccharides; D008562:Membrane Glycoproteins; D000099231:Lipopolysaccharide-Binding Protein