Key result
A personalized platform incorporating chronobiology, immune signatures, and heart rate variability is proposed to improve the efficacy of sepsis treatment by overcoming deleterious compensatory responses.
Why the study?
Sepsis remains a major therapeutic challenge with high morbidity and mortality, characterized by marked inter- and intra-patient variability and dynamic compensatory responses that hinder effective treatment.
Chronotherapy and personalized monitoring of autonomic and immune parameters may improve the efficacy of sepsis treatment by addressing inter- and intra-patient variability.
Hypothesis-generating for chronobiology-integrated sepsis care; randomized trials needed before clinical adoption.
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.
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Kenig et al. (2019) conducted a review in Sepsis. Personalized chronotherapy and variability-based platform was evaluated. A personalized platform incorporating chronobiology, immune signatures, and heart rate variability is proposed to improve the efficacy of sepsis treatment by overcoming deleterious compensatory responses.
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