Abstract
Sepsis remains a major therapeutic challenge and is associated with a high rate of morbidity and mortality. It is a dynamic condition in which multiple parameters change over time, rendering it difficult to overcome the various injurious responses, which worsen the prognosis in these patients. The prognosis of sepsis is associated with a disbalance of compensatory responses to infectious triggers, part of which can be deleterious. Marked inter- and intra-patient variability characterizes the mechanisms that underlie sepsis progression and determine the response to therapy. In this paper, we review some of the data on the use of chronopharmacological approaches for the treatment of patients with sepsis and discuss the role of the autonomic nervous system in the mechanisms associated with immune response and chronotherapy in these patients. We describe the implementation of an individualized platform that is based on the personalized autonomic nervous system, immune, and chronobiology-derived parameters for generating a patient-tailored therapeutic regimen. The notion of overcoming the deleterious compensatory response in a highly dynamic system in sepsis is presented to ensure an improved response to current therapies.
Highlights
Ariel Kenig and Yaron Ilan*Sepsis remains a major therapeutic challenge and is associated with a high rate of morbidity and mortality
Specialty section: This article was submitted to Chronobiology, a section of the journal Frontiers in PhysiologyReceived: 17 October 2019 Accepted: 05 December 2019 Published: 19 December 2019Citation: Kenig A and Ilan Y (2019) APersonalized Signature and Chronotherapy-Based Platform for Improving the Efficacy of Sepsis Treatment
In 2016, the definitions and criteria of sepsis have been revised placing the inflammatory host response as the pivotal cause of multi-organ failure (MOF) (Singer et al, 2016). This process contributes to the absence of response toward the current therapies leading to a high rate of morbidity and mortality (Iskander et al, 2013; Gotts and Matthay, 2016)
Summary
Sepsis remains a major therapeutic challenge and is associated with a high rate of morbidity and mortality. It is a dynamic condition in which multiple parameters change over time, rendering it difficult to overcome the various injurious responses, which worsen the prognosis in these patients. We review some of the data on the use of chronopharmacological approaches for the treatment of patients with sepsis and discuss the role of the autonomic nervous system in the mechanisms associated with immune response and chronotherapy in these patients. The notion of overcoming the deleterious compensatory response in a highly dynamic system in sepsis is presented to ensure an improved response to current therapies
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