Lichtgedanken 03

S C HW E R P U N K T 21 03 | LICHT GEDANKEN tients pass away within a few hours.« It is therefore critical to close funda- mental research gaps. The Jena research campus InfectoGnostics, for instance, has already been working on better and faster procedures. Three partners join their forces and share their expertise in the research campus: the Leibniz Insti- tute for Natural Product Research and Infection Biology, Hans Knöll Institute (HKI), the Jena University Hospital, and the Friedrich Schiller University Jena. Bauer points out the urgency of this research topic: »The number of the septic infections is increasing.« Taking the modern, highly advanced medical technologies into consideration, this may be surprising at first. However, this very medical care provides the favou- rable conditions for invasive infections. »More and more people achieve rather advanced ages. Often, persons over 80 years receive a new knee joint or a hip joint,« explains Bauer. »But even a suc- cessful surgery may weaken the immu- ne system. At that very moment, facul- tative pathogens often hit.« According to him, the human body usually har- bours such germs without developing disease – they only trigger disease un- der certain circumstances. The fungus Candida albicans , for example, colonizes more than 50 percent of the population: it can be found in the mouth and in the throat, in the genital region or in the di- gestive system (see p. 18). »The human immune system limits the success of the modern medicine – it is the Achilles’ heel,« Bauer illustrates. To be more accurate, many drugs and the- rapeutic procedures affect the immune system, and make it more susceptible to pathogens—also to those germs re- siding in the body, for instance Candi- da albicans . In particular the intestinal microbiome, also known as gut flora, which consists of millions of microorga- nisms, is »a decisive factor for the hu- man health«. When these microbes turn against the body, physicians are often at their wits’ end. »It is thus essential for us to understand how microorganisms function in ec- osystems and how they communicate,« Prof. Bauer is firmly convinced. »In this regard, I want to learn from biologists.« Applying their findings to medical pro- blems might lead to completely new perspectives beyond the simple concept of aggressively treating all pathogens with antibiotics. Otherwise the number of multiresistant germs will continue to increase which – in the worst case – may end in a »postantibiotic era« (see the box above). Body has to find the suitable stress response on its own »Finally, a better understanding of microorganisms will help us to find no- vel approaches to strengthen the body’s defence and the immune system. The body itself should find a better stress response to sepsis and become more resistant,« hopes Michael Bauer. »To achieve these goals, it is our top priority to team up and to combine our inter- disciplinary expertise.« Not only sepsis (colloquially: »blood poisoning« ), but also the consequences of this disease pose a heavy burden on patients and their relatives. After awakening from an artificial coma, which might have lasted a few days or several weeks, many patients are unable to move. Often they have to relearn particular body movements whereas the body and the damaged organs have to gradually regain their normal functions. Quite often a lack of oxygen during sepsis cau- ses serious tissue damage on peripheral limbs. As a result, the dead tissue has to be surgically removed, which can include amputations. In addition, patients may face long-term conse- quences , for example weight loss, fatigue, headache, joint and muscle pain. Further problems include cognitive impairment, such as poor concentration and loss of memory, deafness, and paralysis. Finally, the experiences in intensive care can seriously affect patients’ mental health and require therapeutic intervention (see the interview on p. 22). I N F E C T I O N S , S E P S I S A N D T H E I R C O N S E Q U E N C E S Infectious diseases are on the rise throughout the world. More and more pathogens are bec- oming resistant to antibiotics and thus threaten the health of many people. A »postantibiotic era« is looming, in which harmless diseases may end up tragically. A network of leading scientific institutions led by the Leibniz Association and with participation of the Friedrich Schiller University Jena is calling on the next German federal government to increase its support of the struggle against multiresistant pathogens. Research on new therapies and diagnostic procedures requires an improved interdisciplinary collaboration in hospitals as public-private partnerships. In a joint call for action, presented in November 2017 during the World Antibiotic Awareness Week in Berlin, the signatories claim that the patients should benefit from research results earlier than it has been the case until now. (For more details on the appeal, please refer to www.leibniz-ipht.de/fileadmin/user_upload/Aufruf_Infektions- krankheiten.pdf.) On the left photo: Prof. Dr Michael Bauer is one of the three speakers of the Center for Sepsis Control and Care (CSCC). At the Jena University Hospital, the expert in intensive care medicine and his colleagues treat around 400 patients per year suffering from sepsis. For about a quarter of them, the disease is fatal. Among frequent cau- ses of sepsis are bacterial and fungal infections. F E AT U R E