Predicting the Cause and Outcome of Septic Shock in Children
Septic shock, or sepsis, is an infection that activates a person's entire immune system into overdrive. It sets off a chain reaction of events that can ultimately lead to uncontrolled inflammation in the body. The infection can affect a patient's temperature, blood pressure, heart rate, white blood cell count and lung function. It can cause widespread organ failure, and for some, death. Approximately 4,000 children die in the United States each year from septic shock.
Hector Wong, MD, and colleagues at Cincinnati Children's are using genomic applications to identify patients who are at risk of developing adverse outcomes with septic shock. They have identified a potential gene expression signature unique to highrisk children.
"We are trying to determine who will have poor outcomes by identifying questionable gene signatures. Once we do that, we should be able to identify at-risk patients with more accuracy and ultimately tailor our therapy accordingly," says Dr. Wong, professor of pediatrics and director of the Division of Critical Care Medicine at Cincinnati Children's.
Dr. Wong and colleagues are developing new therapeutic targets and technology needed to identify which patients will respond to treatment and which will do poorly. Using microarray technology, they can measure all known genes at the same time from one blood sample. In this way, they perform simultaneous and efficient assessment of gene expression at the level of the entire genome.
Dr. Wong has launched a project supported by the National Institutes of Health in which he and colleagues have developed a national genomic data bank of children with septic shock. Fifteen centers have been established nationwide. "The amount of data that is being generated is astronomical. Cataloguing and analyzing data is a very difficult task," Dr. Wong says. "A good analogy is if I gave my 4-year-old all of the parts of a Porsche without instructions and asked her to put it together. This is where bioinformatics and computational medicine come into play."
