Eyeing the storm
Sepsis research targets treatment for cytokine storm, which may also benefit patients with COVID-19
BY EMILY KULKUS
A new type of sepsis treatment investigated by a team of researchers at Upstate could bolster survival rates — and be useful in treating severe cases of COVID-19.
Sepsis is a potentially life-threatening condition caused by the body’s response to an infection. It affects 1.7 million adults in the United States each year and contributes to more than 270,000 deaths.
When the body’s immune system fights an infection, it releases a group of proteins called cytokines, which control inflammation in the body. Sometimes the body goes into overdrive, releasing more cytokines than it should, producing what’s known as a cytokine storm. This can lead to organ failure and death.
A cytokine storm or hyperinflammation syndrome has been documented in many patients with severe cases of COVID-19, tied to the coronavirus pandemic. Researchers believe their new therapy might help.
“We are targeting the cytokine storm and inflammatory mediators,” describes Juntao Luo, PhD, an associate professor of pharmacology. He leads the team that has been studying a way to neutralize severe inflammation during sepsis for the last three years.
“Inflammation is a double-bladed sword, as it is meant to control infection naturally but can cause tissue damage if unchecked,” he explains. “Inflammation in a sepsis patient is really hard to control, and for many patients they cannot overcome that and may die.”
Sepsis is usually treated with antibiotics plus supportive measures, including intravenous fluids, medications to support blood pressure and mechanical ventilation or dialysis, to support injured lungs or kidneys.
Luo worked with professor and Chair of Surgery Robert Cooney, MD, to develop new nanotrap technology that absorbs excessive inflammatory mediators in the blood. When paired with antibiotics, their new treatment dramatically increased survival rates in experimental models.
“With antibiotics alone to control infection we get a 50 to 60 percent survival rate,” Luo explains. “Our new approach to control inflammation also gives us a 50 to 60 percent rate.
“But when they are combined, the survival rate is 100 percent. This technology can be used as a blood-cleaning therapy and is promising to improve the survival rate of severe sepsis.”
A paper describing their work — “A Nanotrap Improves Survival in Severe Sepsis by Attenuating Hyper-inflammation” — was published recently in the scientific journal Nature Communications. The summary says that “in addition to reducing the inflammatory effects of infection, the nanotrap technology decreased injury to lung, kidney and liver and also improved survival.”
The research is supported by several grants from the National Institutes of Health. Other Upstate contributors to the project are: Changying Shi, Xiaojing Wang, Lili Wang, Qinghe Meng, Dandan Guo and Guirong Wang.
Li Chen from Baylor Scott and White Medical Center in Temple, Texas, and Matthew Dai, formerly of Upstate and now from Brown University, also contributed.
Doctors at Upstate have been pooling their expertise through the Sepsis Interdisciplinary Research Center since the summer of 2019. Luo’s work is one of the center’s primary projects.
Cooney says Upstate physicians and researchers involved in the center are studying sepsis, infection and organ failure. The group meets regularly to share research and collaborate on
projects such as this one to develop integrative therapies for sepsis and critical illness.
“Sepsis is a critically important public health problem,” he says. “Upstate is trying to combine our energies and expertise to improve outcomes.”
Learn more about sepsis research at www.upstate.edu/pharm/sirc