A new test and treatment for severe sepsis, the leading cause of death from infection globally, is the focus of groundbreaking research taking place at St. Paul’s.
Doctors at St. Paul’s are developing a test to detect the early stages of severe sepsis, a condition that affects millions of Canadians each year and is a leading cause of death worldwide.
Severe sepsis is a condition in which harmful pathogens, such as bacteria and fungi, overwhelm the body’s immune system, causing blood pressure to drop to dangerously low levels and potentially leading to organ failure. The challenge for medical practitioners is to know which patients who enter the hospital’s emergency department could go on to develop severe sepsis.
Research conducted by Dr. John Boyd, a critical care physician at St. Paul’s and the Centre for Heart Lung Innovation at St. Paul’s, and his colleagues, has so far identi- fied 31 key genes, or markers, that can show patients’ risk of developing severe sepsis based on the results of a simple blood test taken upon their admission to hospital.
“This blood test could be a game- changer,” says Boyd. “We would like to see it being used at hospitals as a way to detect the early stages of sepsis so that we can intervene before a patient’s condition becomes critical.”
That’s why Boyd says the test they are developing would need to have a turnaround time of approximately one hour between the time the blood work is taken and the results are received. Those results would show if a patient is at risk of developing severe sepsis and should be admitted to the intensive care unit – where he or she would receive critical care services – rather than to the general medicine ward. The results would also give staff more information about which medica- tions, such as antibiotics and corticosteroids, to administer.
“It would be a big step forward,” says Boyd. “This test could help us match patients with the right departments in the hospital and the right treatments.”
Boyd and colleagues at St. Paul’s are also researching a medication that could stop sepsis in its tracks.
Harmful particles from dead or alive pathogens are mostly carried in fatty mol- ecules, such as cholesterol, in the bloodstream, and researchers have found that flushing these toxic fatty molecules from the blood also removes a lot of pathogens.
The medication that Boyd and his colleagues are working on would more quickly remove toxic fatty molecules from a patient’s bloodstream for a limited amount of time, thus controlling a potentially harmful immune system response and giving the patient a better chance of recovery.
The results of Boyd and his colleagues’ initial findings were published in the journal Science Translational Medicine online, and a clinical trial into the use of the new medication is set to begin at St. Paul’s this year.
“We’re going to be looking at the best way to deliver this therapy to patients through the clinical trial,” says Boyd. “We hope it can be used to treat patients at St. Paul’s and beyond in the near future.”
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