Endothelial Damage in Sepsis: The Importance of Systems Biology

Jaime Fernández-Sarmiento; Luregn J. Schlapbach; Lorena Acevedo; Carolina Ramírez Santana; Yeny Acosta; M. Monsalve; Joseph A. Carcillo

doi:10.3389/fped.2022.828968

Endothelial Damage in Sepsis: The Importance of Systems Biology

Jaime Fernández-Sarmiento, Luregn J. Schlapbach, Lorena Acevedo, Carolina Ramírez Santana, Yeny Acosta, M. Monsalve, Joseph A. Carcillo

Producción científica: Contribución a una revista › Artículo de revisión › revisión exhaustiva

7 Citas (Scopus)

Resumen

El diagnóstico precoz y la estratificación adecuada de la sepsis siguen siendo uno de los retos más importantes de la medicina moderna. Los biomarcadores aislados no han sido suficientes para mejorar las estrategias de diagnóstico y pronóstico ni para avanzar hacia los objetivos terapéuticos. La información generada por el proyecto del genoma humano ha permitido un enfoque más holístico del problema. La integración de la genómica, transcriptómica, proteómica y metabolómica en la sepsis nos ha permitido avanzar en el conocimiento de nuevas vías implicadas fisiopatológicamente en esta enfermedad. Así, hemos comprendido la importancia y la compleja interacción entre la respuesta inflamatoria y el endotelio. La comprensión del papel de partes importantes de la microcirculación, como el glicocálix endotelial y su interacción con la respuesta inflamatoria, ha proporcionado elementos de reconocimiento precoz para la práctica clínica que permiten el uso racional de las intervenciones médicas tradicionales en la sepsis. Este enfoque integral, que difiere del enfoque mecanicista clásico, utiliza la biología de sistemas para aumentar el espectro diagnóstico y pronóstico de los biomarcadores de daño endotelial en la sepsis, y para proporcionar información sobre nuevas vías implicadas en la fisiopatología de la enfermedad. Esto, a su vez, proporciona herramientas para perfeccionar las intervenciones médicas tradicionales, utilizándolas en los momentos adecuados según el contexto fisiopatológico de la enfermedad, al tiempo que se descubren nuevas y mejores alternativas terapéuticas. Tenemos el reto de trasladar este escenario ideal a nuestra práctica clínica diaria para mejorar la atención a nuestros pacientes. El propósito de este artículo es ofrecer una descripción general de la importancia de la biología de sistemas en la integración de la compleja interacción entre el endotelio y la respuesta inflamatoria en la sepsis.

Idioma original	Inglés estadounidense
Número de artículo	828968
Páginas (desde-hasta)	1-10
Número de páginas	10
Publicación	Frontiers in Pediatrics
Volumen	12
DOI	https://doi.org/10.3389/fped.2022.828968
Estado	Publicada - mar. 9 2022

Áreas temáticas de ASJC Scopus

Pediatría, perinaltología y salud infantil

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

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10.3389/fped.2022.828968

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title = "Endothelial Damage in Sepsis: The Importance of Systems Biology",

abstract = "The early diagnosis and appropriate stratification of sepsis continues to be one of the most important challenges in modern medicine. Single isolated biomarkers have not been enough to improve diagnostic and prognostic strategies and to progress toward therapeutic goals. The information generated by the human genome project has allowed a more holistic approach to the problem. The integration of genomics, transcriptomics, proteomics and metabolomics in sepsis has allowed us to progress in the knowledge of new pathways which are pathophysiologically involved in this disease. Thus, we have understood the importance of and complex interaction between the inflammatory response and the endothelium. Understanding the role of important parts of the microcirculation, such as the endothelial glycocalyx and its interaction with the inflammatory response, has provided early recognition elements for clinical practice that allow the rational use of traditional medical interventions in sepsis. This comprehensive approach, which differs from the classical mechanistic approach, uses systems biology to increase the diagnostic and prognostic spectrum of endothelial damage biomarkers in sepsis, and to provide information on new pathways involved in the pathophysiology of the disease. This, in turn, provides tools for perfecting traditional medical interventions, using them at the appropriate times according to the disease's pathophysiological context, while at the same time discovering new and improved therapeutic alternatives. We have the challenge of transferring this ideal scenario to our daily clinical practice to improve our patients' care. The purpose of this article is to provide a general description of the importance of systems biology in integrating the complex interaction between the endothelium and the inflammatory response in sepsis.",

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AB - The early diagnosis and appropriate stratification of sepsis continues to be one of the most important challenges in modern medicine. Single isolated biomarkers have not been enough to improve diagnostic and prognostic strategies and to progress toward therapeutic goals. The information generated by the human genome project has allowed a more holistic approach to the problem. The integration of genomics, transcriptomics, proteomics and metabolomics in sepsis has allowed us to progress in the knowledge of new pathways which are pathophysiologically involved in this disease. Thus, we have understood the importance of and complex interaction between the inflammatory response and the endothelium. Understanding the role of important parts of the microcirculation, such as the endothelial glycocalyx and its interaction with the inflammatory response, has provided early recognition elements for clinical practice that allow the rational use of traditional medical interventions in sepsis. This comprehensive approach, which differs from the classical mechanistic approach, uses systems biology to increase the diagnostic and prognostic spectrum of endothelial damage biomarkers in sepsis, and to provide information on new pathways involved in the pathophysiology of the disease. This, in turn, provides tools for perfecting traditional medical interventions, using them at the appropriate times according to the disease's pathophysiological context, while at the same time discovering new and improved therapeutic alternatives. We have the challenge of transferring this ideal scenario to our daily clinical practice to improve our patients' care. The purpose of this article is to provide a general description of the importance of systems biology in integrating the complex interaction between the endothelium and the inflammatory response in sepsis.

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Endothelial Damage in Sepsis: The Importance of Systems Biology

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