Magnetic sieve to treat sepsis

British newspaper The Daily Mail reported on May 23, 2017, the invention of a magnetic device that could filter the deadly bacteria and their toxins from the blood of ‘sepsis’ patients (sepsis is a condition wherein the body mounts a humongous immune response to the invading micro-organisms). This invention has far reaching consequences for the medical treatment of sepsis which normally has a high mortality rate of 30-50%.  All the deadly bacteria and toxic chemicals that are produced in the body which triggers the “septic shock” can be removed while pure blood is pumped back into the body — like in dialysis. Dr George Frodsham, a British scientist designed this magnetic sieve while doing his PhD at University College, London.

The magnetic sieve has proved successful in the initial laboratory trials and is now ready to undergo human clinical trials next year. If these trials are positive, then this device could be an important therapeutic tool to combat sepsis with the potential to save thousands of lives. It also has scope in the treatment of malaria and leukaemia.

Dr Frodsham’s invention is useful to quickly flush out dangerous toxins from the blood. Once a doctor confirms that sepsis has set in, the blood is collected from the patient’s vein and fed into this newly invented magnetic device. The bacteria and endotoxins then get bound to magnetic particles in the device. These small bead-like magnetic particles which have all the bound bacteria are held back in a strong magnetic sieve. The clean blood is then pumped back into the patient’s body. The whole process takes only a couple of hours.

The main challenge for the medical community to treat sepsis is an extremely short span of time between the onset of prominent symptoms and death. The symptoms may include increased pulse rate, shivering, high fever, sweaty skin, disorientation, body pain and shortness of breath. But all these could be associated with some other diseases too and therefore can lead to confusion in ascertaining the exact cause. Hence, it is important to have some biomarker analysis and ascertain whether it is sepsis or not.

The earlier the doctors are able to diagnose symptoms of sepsis, the greater the chances for the patient to elude an untimely death. Sepsis need not be always associated with serious diseases or infections. Even a seemingly minor infection or small wound could be potentially dangerous. People older than 65 years or under age one year and patients with weakened immune systems or chronic medical conditions like diabetes are more prone to sepsis.

During infection, many bacteria release toxins like lipopoly­saccharides and galactosamine into the blood. So even if we kill bacteria with antibiotics, the dead remains of the bacterial cells can act as endotoxins which can elicit a massive release of many chemicals like cytokines by the immune system.

Organ failure

This can cause inflammation in several parts of the body and start damaging organs. Very soon, this can lead to shut down of all important organs and the immediate cause of death will be multiple organ failure. Hence it is imperative to block or revert this septic cascade in the blood stream.

More than one lakh people die in India due to septic shock. This death toll is alarming. The death of Tamil Nadu Chief Minister Jayalalithaa was also attributed to septic shock leading to organ failure. What is unbelievable is the pace at which a patient progresses from a normal healthy condition to a life-threatening situation.

This particular feature of sepsis demands two measures: i) a rapid detection system so that doctors can be alerted to intervene; (ii) a reliable and easy therapeutic measure which can quickly undo the serious damage caused in the body.

According to a report in the New England Journal of Medicine, every additional delay in starting the treatment can increase the chances of death by 4%. Each minute is precious when it comes to correct diagnosis and start the treatment strategy. Most often, by the time, the doctor realises that sepsis has set in, things would have gone out of control due to an avalanche of endotoxins produced by the bacteria which in turn induces the immune system to react violently causing the “septic cascade.”

According to a study published in Lancet Global Health, sepsis is one of the three most common causes of neonatal deaths globally. Another study conducted by Centre for Disease Control, Atlanta, USA, has revealed that nearly 80% of sepsis cases initiated outside hospitals and not in ICUs.

In India, a 2016 study revealed that 26% of the patients in ICUs contracted sepsis and the mortality rate was over 40%. The number of deaths caused by septic shock far exceeds that caused by breast cancer, prostate cancer etc. Yet another problem is the lack of awareness about this condition in our country. Hence, it is wise to be equipped with an armour of potential diagnostic and therapeutic measures against this serious condition.

(The writer is Assistant Professor, Department of Life Sciences, Christ University, Bengaluru)