Special issue: Sepsis Why have clinical trials in sepsis failed?

被引：564

作者：

Marshall, John C. ^{[1
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机构：

[1] St Michaels Hosp, Dept Surg & Crit Care Med, Toronto, ON M5B 1W8, Canada

[2] St Michaels Hosp, Keenan Res Ctr Biomed Sci, Toronto, ON M5B 1W8, Canada

[3] Univ Toronto, Interdept Div Crit Care Med, Toronto, ON, Canada

来源：

TRENDS IN MOLECULAR MEDICINE | 2014年 / 20卷 / 04期

关键词：

sepsis; septic shock; clinical trials; staging; innate immunity; adjuvant therapy; intensive care; biologic response modifier; TUMOR-NECROSIS-FACTOR; HUMAN MONOCLONAL-ANTIBODY; GRAM-NEGATIVE BACTEREMIA; SEPTIC SHOCK; DOUBLE-BLIND; DIRECTED THERAPY; EFFICACY; ENDOTOXIN; SURVIVAL; SAFETY;

D O I：

10.1016/j.molmed.2014.01.007

中图分类号：

Q5 [生物化学]; Q7 [分子生物学];

学科分类号：

070307 [化学生物学]; 071010 [生物化学与分子生物学];

摘要：

The systemic inflammatory response is biologically complex, redundant, and activated by both infectious and noninfectious triggers. Its manipulation can cause both benefit and harm. More than 100 randomized clinical trials have tested the hypothesis that modulating the septic response to infection can improve survival. With one short-lived exception, none of these has resulted in new treatments. The current challenge for sepsis research lies in a failure of concept and reluctance to abandon a demonstrably ineffectual research model. Future success will necessitate large studies of clinical and biochemical epidemiology to understand the course of illness, better integration of basic and clinical science, and the creation of stratification systems to target treatment towards those who are most likely to benefit.

引用

页码：195 / 203

页数：9

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