Promising prospects on the application of extracellular vesicles for treating sepsis patients, but not without appropriate standardization of existing and development of new diagnostic methods – this is the core message of a paper written by an interdisciplinary team consisting of Pierre Raeven and LBI scientists Johannes Zipperle and Susanne Drechsler. It was recently published in the international Journal Theranostics.
Sepsis, a life-threatening condition due to a misdirected immune reaction, affects 270 in 100 000 persons per year. One out of four sepsis patients dies despite appropriate medical treatment. The work of Pierre Raeven and his colleagues focuses on discovering reliable biomarkers – indicators that can aid in predicting occurrence and progression of the disease. Extracellular vesicles (EV) are tiny bubbles (30 nanometer to several micrometer in size) that are released by a cell following its activation in course of an infection. On their surface the carry molecules that are characteristic for their cellular origin and thus could be used as biomarker.
With dedicated support from Marcin Osuchowski, head of the intensive care research department at the LBI Trauma, the authors perform their extensive review of current studies highlighting the role of EV in sepsis patients, with special focus on the quality and clinical applicability of these studies. Moreover they discuss the diagnostic and therapeutic potential of EV as well as their role in cell communication.
Another focus of their work lies on the consideration of the quite ambiguous nature of EV – they appear to be able to play an essential part in immune responses, but also accelerate the inflammatory response. The “friendly” or “hostile” nature of EV is probably linked to their cellular origin and depends on what molecules are displayed on their surface.
The ability to transport molecules turns EV into potential candidates for the transportation of therapeutic substances. This could enable more precise, personalized therapy in the future.
Considerations on the role of EV in sepsis patients with special conditions, such as coagulopathies, or in combination with blood transfusions or mechanical ventilation are also discussed in course of the extensive review.
However, prior to all of those potential diagnostic and/or therapeutic applications, the methodical development for the detection of EV has to be driven forward.
That art and science are not that far away from each other is shown in course of the publication: the figures made by co-authoring LBI scientist Dr. Johannes Zipperle were drawn with meticulous precision by hand and only edited digitally in a last step. This “vintage look” delighted the editors of Theranostics and they rewarded this high level of dedication with a place on the cover.