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Review
. 2024 Apr 12:24:292-305.
doi: 10.1016/j.csbj.2024.04.020. eCollection 2024 Dec.

Glucocorticoid therapy for sepsis in the AI era: a survey on current and future approaches

Chenglong Liang  1   2   3 , Shuo Pan  2 , Wei Wu  4 , Fanxuan Chen  2   5 , Chengxi Zhang  6 , Chen Zhou  1 , Yifan Gao  7 , Xiangyuan Ruan  1 , Shichao Quan  8 , Qi Zhao  4 , Jingye Pan  1   7   9   10   11
Affiliations
Review

Glucocorticoid therapy for sepsis in the AI era: a survey on current and future approaches

Chenglong Liang et al. Comput Struct Biotechnol J. .

Abstract

Sepsis, a life-threatening medical condition, manifests as new or worsening organ failures due to a dysregulated host response to infection. Many patients with sepsis have manifested a hyperinflammatory phenotype leading to the identification of inflammatory modulation by corticosteroids as a key treatment modality. However, the optimal use of corticosteroids in sepsis treatment remains a contentious subject, necessitating a deeper understanding of their physiological and pharmacological effects. Our study conducts a comprehensive review of randomized controlled trials (RCTs) focusing on traditional corticosteroid treatment in sepsis, alongside an analysis of evolving clinical guidelines. Additionally, we explore the emerging role of artificial intelligence (AI) in medicine, particularly in diagnosing, prognosticating, and treating sepsis. AI's advanced data processing capabilities reveal new avenues for enhancing corticosteroid therapeutic strategies in sepsis. The integration of AI in sepsis treatment has the potential to address existing gaps in knowledge, especially in the application of corticosteroids. Our findings suggest that combining corticosteroid therapy with AI-driven insights could lead to more personalized and effective sepsis treatments. This approach holds promise for improving clinical outcomes and presents a significant advancement in the management of this complex and often fatal condition.

Keywords: Artificial intelligence; Glucocorticoid therapy; Sepsis; Therapeutic strategies.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

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Graphical abstract
Fig. 1
Fig. 1
Glucocorticoids are adrenocorticotropic hormones that regulate substance synthesis and metabolism via the hypothalamic-pituitary-adrenal (HPA) axis, as well as anti-inflammatory effects. It has an important role in sepsis. In patients with sepsis, the immune system is activated to eliminate the source of infection. However, if not properly balanced, pathogen clearance is associated with excessive inflammation leading to organ failure. Sepsis also leads to dysregulation of the immune response and consequent metabolic changes, such as changes in blood glucose. Severe sepsis can also lead to circulatory instability and signs of shock. Glucocorticoids are induced during infection to maintain homeostasis and to withstand the life-threatening effects of sepsis on the host.
Fig. 2
Fig. 2
In our research on AI in sepsis, we delineate five main aspects of sepsis. At the same time, we elucidate some of the most widely used AI models in this research area.
Fig. 3
Fig. 3
Glucocorticoid dosing and efficacy are governed by an intricate interplay of factors. As delineated in the figure, these span intrinsic patient-specific attributes and extrinsic determinants.
See this image and copyright information in PMC

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