Pediatric septic shock continues to be an important public health problem. Several investigative groups have applied genetic and genomic approaches as a means of identifying novel pathways and therapeutic targets, discovery of sepsis
-related biomarkers, and identification of septic shock subclasses. This review will highlight studies in pediatric sepsis
with a focus on gene association studies and genome-wide expression profiling
A summary of published literature involving gene association and expression profiling
studies specifically involving pediatric sepsis
and septic shock.
Several polymorphisms of genes broadly involved in inflammation, immunity, and coagulation have been linked with susceptibility to sepsis
, or outcome of sepsis
. Many of these studies involve meningococcemia, and the strongest association involves a functional polymorphism
of the plasminogen activator inhibitor-1 promoter region and meningococcal sepsis
. Expression profiling
studies in pediatric septic shock have identified zinc supplementation and inhibition of matrix metalloproteinase-8 activity as potential, novel therapeutic approaches in sepsis
. Studies focused on discovery of sepsis
-related biomarkers have identified interleukin-8 as a robust outcome biomarker in pediatric septic shock. Additional studies have demonstrated the feasibility and clinical relevance of gene expression-based subclassification of pediatric septic shock.
and septic shock are increasingly being studied by genetic and genomic approaches and the accumulating data hold the promise of enhancing our future approach to this ongoing clinical problem.