Genetic epidemiology of sepsis and septic shock.
Sepsis affects more than 750,000 people each year in the United States alone, with a mortality rate of over 35% making it one of the leading causes of death in developed countries. Recent genetic analysis has provided us with several candidate genes, which have become the focus of genetic research in sepsis. The analysis of single nucleotide polymorphisms among various genes, such as those coding for pro- and antiinflammatory mediators, in the septic response has the potential to develop into prediction tools that will permit the clinician to more precisely determine the type of therapy that a particular patient should receive. However, unraveling the genetic variation in sepsis is complicated, and close attention must be paid to study design issues, including the selection of an appropriate study population and sample size and understanding gene-environment interactions. We must anticipate that future implementation of genetic information will lend itself to additional ethical dilemmas when we are faced with allocation of resources.
Wood
Kelly A
KA
The CRISMA Laboratory (Clinical Research, Investigation, and Systems Modeling of Acute Illness), Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennslvania, USA.
Angus
Derek C
DC