Tribute to translation - Translational medicine has been defined as an “interdisciplinary branch of the biomedical field to promote enhancements in prevention, diagnosis, and therapies supported by three main pillars: benchside, bedside and community” (Cohrs RJ, New Horizons in Translational Medicine 2014).
Over the last 25 years of sepsis research, numerous benchside success stories stranded on the road to translation, by showing no incremental benefits over standard care. “Death valleys” for translational progress in sepsis research include limitations of benchside sepsis modeling or pitfalls in bedside sepsis traditional trial designs thereby ignoring the heterogeneity of treatment effects. Moreover, multiple sepsis definitions and terminologies have been used leading to discrepancies in reported incidence and observed mortality.
However, there is hope on the horizon, coming from the next generation of biomedical sepsis researchers who pay tribute to the obstacles in the translational process: In February 2016, the SEPSIS-3 task force newly defined sepsis as a life-threatening organ dysfunction caused by a dysregulated host response to infection and systematically developed criteria for clinical operationalization (Singer M, JAMA 2016).
Adaptive enrichment designs by using bio-markers for prognostic evaluation or to predict treatment response have been recently proposed by researchers of the ARDS network trials (Famous KR, AJRCCM 2017). Adaptive clinical trial designs for sepsis had been developed by a group of researchers from Pittsburgh. These pragmatic trials facilitate the investigation of several candidate treat-ments simultaneously, learn from emergent discoveries and shorten timely conclusions compared to traditional trial designs (Talisa VB, Frontiers in Immunology 2018).
In 2017, a European Group on Immunology of Sepsis (EGIS) had been established. EGIS, a multidisciplinary group, con-sists of basic scientists, immunologists, infectious diseases and intensive care medicine specialists with a shared primary research interest in sepsis immunology (Bermejo-Martin JF, Shock 2018). In 2017 a group of researchers initiated the Wiggers-Bernard Conference in Vienna on pre-clinical sepsis modeling to identify a “Minimum Quality Threshold in Pre-Clinical Sepsis Studies (MQTiPSS)” ) for improvement of animal modeling in sepsis. Recommendations were published simultaneously in three major journals recently (Osuchowski MF, Intensive Care Medicine 2018; Shock 2018; Infection 2018). A large international trial (REMAP-CAP) will start in 2018 (ClinicalTrials.gov Identifier: NCT02735707).
Finally, the German Sepsis Society will publish their S-3 guidelines on sepsis management in 2019.
Tribute to Translation - the 9th international Weimar Sepsis Update 2019 is dedicated to the four challenges of sepsis management: Bugs, Drugs, Damage and Repair. Get up to date on the current state of knowledge, top publications from top researchers in basic and clinical research!
Prof. Markus Weigand, Chairman
Prof. Frank M. Brunkhorst, Secretary General
Maria Kortgen, DGF Landesbeauftragte