Sepsis ‘breakthrough’: the world’s first targeted treatment?

Sepsis is one of the leading causes of death and disability worldwide. It can affect anyone, and is notoriously difficult to diagnose in the early stages, and to treat once it becomes life-threatening. Now scientists in Australia are getting close to unlocking the first specific sepsis treatment.

The current first-choice treatment for sepsis focuses on using broad-spectrum antibiotics to attack the pathogen causing the condition. But there are an increasing number of antibiotic-resistant pathogens that can cause sepsis. “This is the nightmare that keeps my colleagues working in public health awake at night,” one doctor told The Telegraph.

The new drug has been developed by researchers at Australia’s Griffith University to target and reverse the sepsis, rather than destroy the pathogen that’s causing it. Its recent Phase II human clinical trial in China showed “promising results in reducing sepsis”, said Science Daily. This is “a major step forward”.

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What is sepsis?

Essentially, the body’s extreme response to an often minor bacterial, viral, fungal or parasitical infection. Our immune system goes into overdrive trying to fight the infection off, triggering inflammation that can impair blood flow and damage tissues and organs. Without treatment, sepsis can quickly lead to septic shock and multiple organ failure. Anyone can develop sepsis, but it’s more prevalent among the very young, the elderly, the diabetic, the immunocompromised and women who have recently given birth.

If you are treated swiftly, you can make a full recovery. But the longer you wait for a diagnosis, the higher the risk. Sepsis causes more than 10 million deaths a year worldwide: about one person every three seconds.

How is it diagnosed?

Sepsis is often called “the silent killer” because the wide variety of pathogens that can cause it may initially trigger very different symptoms, making it hard for medics to spot soon enough. Warning signs in a child – fever, chills, lethargy, fast heartbeat or breathing, blotchy skin and/or a rash that doesn’t fade (as with meningitis) – can mirror many less serious conditions. For adults, symptoms include slurred speech or confusion, extreme shivering, lack of urination, mottled skin, severe breathlessness and a feeling of doom.

There is currently no one diagnostic test; just different tests, that typically take hours, to confirm the presence, and possibly the type, of infection. The NHS is currently trialling a rapid blood test to identify if a patient has a viral or bacterial infection, which could speed up some diagnoses of sepsis considerably. Doctors who participated in the trial, which concludes in March, have already “witnessed the benefits”, according to The Guardian.

What is the new drug?

Known as STC3141, it is a carbohydrate-based drug administered as an infusion through a cannula. It works by “calming” and counteracting the “major biological molecule release” that occurs during the body’s immune overreaction, and helps to treat sepsis by “reversing the damage to organs rather than only managing symptoms”, said Science Daily.

The research team now plans to move onto Phase III effectiveness trials. “It’s hoped we could see the treatment reach the market in a handful of years, potentially saving millions of lives,” said team leader Mark von Itzstein.

What else might help?

Artificial intelligence may help medics detect sepsis earlier. US researchers at Northeastern University have been training an AI model on patient data collected at urgent care centres, in ambulances and in hospital. The model was able to predict septic shock with over 99% accuracy, according to a study published in Life last October.

“If sepsis is diagnosed in the emergency room, probably the best-case scenario is to pray because the survival rate is extremely low,” lead researcher Sergey Aityan told the university’s Northeastern Global News. “Our system is like an immediate second opinion, which is practically impossible to do in emergency settings with physical doctors.”