The Immunology Of Sepsis Understanding Host Susceptibility Pathogenesis Of Disease And Avenues For Future Treatment

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Humans coexist with millions of harmless microorganisms, but emerging diseases, resistance to antibiotics, and the threat of bioterrorism are forcing scientists to look for new ways to confront the microbes that do pose a danger. This report identifies innovative approaches to the development of antimicrobial drugs and vaccines based on a greater understanding of how the human immune system interacts with both good and bad microbes. The report concludes that the development of a single superdrug to fight all infectious agents is unrealistic.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

For many years, experiments using chimpanzees have been instrumental in advancing scientific knowledge and have led to new medicines to prevent life-threatening and debilitating diseases. However, recent advances in alternate research tools have rendered chimpanzees largely unnecessary as research subjects. The Institute of Medicine, in collaboration with the National Research Council, conducted an in-depth analysis of the scientific necessity for chimpanzees in NIH-funded biomedical and behavioral research. The committee concludes that while the chimpanzee has been a valuable animal model in the past, most current biomedical research use of chimpanzees is not necessary, though noted that it is impossible to predict whether research on emerging or new diseases may necessitate chimpanzees in the future.

Microbial endocrinology represents a newly emerging interdisciplinary field that is formed by the intersection of the fields of neurobiology and microbiology. This book will introduce a new perspective to the current understanding not only of the factors that mediate the ability of microbes to cause disease, but also to the mechanisms that maintain normal homeostasis. The discovery that microbes can directly respond to neuroendocrine hormones, as evidenced by increased growth and production of virulence-associated factors, provides for a new framework with which to investigate how microorganisms interface not only with vertebrates, but also with invertebrates and even plants. The reader will learn that the neuroendocrine hormones that one most commonly associates with mammals are actually found throughout the plant, insect and microbial communities to an extent that will undoubtedly surprise many, and most importantly, how interactions between microbes and neuroendocrine hormones can influence the pathophysiology of infectious disease.

The incidence of sepsis is increasing as new medical and surgical technologies are applied to an increasingly aging patient population. The treatment of sepsis emphasizes strategies to avoid multiple organ dysfunction, with particular attention to establishing source control, and then modifies the host's response to the excessive inflammatory response which characterizes sepsis. This book is a comprehensive review by internationally recognized experts of the epidemiology, monitoring and treatment of sepsis. Using an "evidence-based" approach, it comprises an extensive review of the literature on sepsis, provides up-to-date recommendations for monitoring and treating sepsis patients, and concludes with explicit recommendations for the design and monitoring of future clinical trials.