Sepsis research at UCSF. UCSF has a long and rich history of studying patients with sepsis to understand its contribution to the development of acute respiratory failure, specifically acute lung injury, and multiple organ failure. There have been several studies completed at UCSF supported by NIH R01 grants to study the role of biologic markers for understanding pathogenesis and prognosis in sepsis. Furthermore the patients with the highest mortality in the NHLBI ARDS Network have been those with sepsis. UCSF is a site for the ARDS Network Phase III Clinical Trials since 1995. At UCSF, our group of Pulmonary and Critical Care Medicine specialists have active research programs that have novel approaches to early diagnosis, pathogenesis, and treatment of sepsis. These programs include:
- Laboratory-based molecular, cell, and animal studies of sepsis in mice, rats, and large animals (including sheep) with a focus on better insights into the pathogenesis and potential treatment pathways for severe sepsis.
- Allogeneic human bone marrow-derived mesenchymal stem cells are being tested in animal models of sepsis, including a novel ex vivo perfused human lung preparation.
- Another focus is the potential role of platelets and the therapeutic value of platelet inhibitors on lung infection that often leads to sepsis.
- There is a new exciting program researching the influence of passive and active cigarette smoke exposure on the development of multiple organ failure following sepsis from a pulmonary or non-pulmonary cause.
- There is also a program studying candidate genes that may predispose specific groups of patients, including African-Americans, to the development of sepsis and organ failure from serious infections.
- There is a particular interest in the role of the noradrenergic sympathetic system in regulating host response to localized and systemic infection.
- New studies have also been initiated to evaluate the potential importance of epigenetic changes or alterations in patients with sepsis that may predispose them to the development of multiple organ failure.
- There is ongoing participation in a phase III NHLBI ARDS Network clinical trial to test the role of statins in reducing the sequelae of acute lung injury from infectious causes.
- There is a major clinical research program to study patients early in their clinical course, specifically in the Emergency Department, prior to admission to the ICU, in order to identify clinical and biologic markers that provide insight into the pathogenesis and prognosis of patients with sepsis.
The research environment encompasses both basic laboratory and clinical research and includes important collaboration with fellows and faculty from the departments of Anesthesia, Pediatrics, Surgery, Medicine and the Cardiovascular Research Institute. There are fellows, Assistant Professors, Associate Professors, and Professors involved in all of this basic and clinical research.