Researchers have found that elevated levels of chlorinated lipids are linked to sepsis, lung injury and death. The study finding, published in the Journal of Clinical Investigation Insight, may offer a way to diagnose and treat sepsis earlier, saving lives and avoiding serious side effects.

Sepsis is a dangerous immune response to an infection in which the whole body becomes inflamed. It carries a high mortality rate as well as high risk of complications from massive drops in blood pressure and organ failure. The key challenge in treating sepsis is to diagnosis it and begins antibiotics quickly; as organs begin to shut down, treating sepsis becomes a matter of beating the clock.

The researchers discovered chlorinated lipids that are made in the body under conditions where there is inflammation. In the study, researchers examined blood samples taken soon after admission to the hospital from patients who were eventually diagnosed with sepsis. They found that chlorinated lipids were present in the blood.

The team also predicted whether a patient would go on to suffer acute respiratory distress symptom (ARDS) and predicted whether patients would die within 30 days from a lung injury. Chlorinated lipids appear to serve as a very early warning sign that a patient is on track for a severe lung injury that could be fatal.

Researchers found that chlorinated lipids are generated by enzymes in neutrophils. When the body is fighting an infection, neutrophils kill microbes. In the process of fighting off the intruder, chlorinated lipids are generated as a by-product. They are the collateral damage that occurs to a patient's own tissue by its immune system.

The team made an analog of a chlorinated lipid that allowed to track where the lipid travels within the endothelial cells in the linings of blood and lymph vessels. The analog goes very specifically to a granule within an endothelial cell, called a Weibel-Palade body (contain proteins that are responsible for inflammation at the site where blood interfaces with the small blood vessels of an organ, the microcirculation, which is associated with organ injury and edema).

The findings set the stage for two strategies against sepsis. First, if researchers can develop a rapid test for chlorinated fatty acids in the clinic, they could begin treatment sooner and buy time for patients. The faster a patient is put on them, the greater survival and fewer side effects.  Second, if chlorinated lipids are indeed causative, then molecules could be developed to block their action, leading to a potential new therapy to stop sepsis-caused organ injury and death.

Investigators had learned that elevated levels of chlorinated lipids could serve as a biomarker, a sign post that appeared when the body became inflamed. The research suggests that chlorinated lipids do cause injury in the microcirculation of the lung. The data suggests chlorinated lipids have a causative role.