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Support from the Society of Critical Care Medicine’s (SCCM) 2015 SCCM-Weil Research Grant enabled Faheem Guirgis, MD, to conduct research centered on the role of dysfunctional high-density lipoprotein in severe sepsis. Dr. Guirgis, an assistant professor of emergency medicine at UF Health Jacksonville, took time out of his busy schedule to provide this brief write-up detailing his research and its progress.
Sepsis is a bridge between many clinical specialties. As an emergency physician, I became fascinated with this disease during residency and studied so I could become proficient in caring for septic patients. But as I learned more, I realized that I had more questions than answers. Not only was clinical care for septic patients challenging for many reasons, but I found gaps in our ability to recognize sepsis and prognosticate outcomes.
Recognizing a lack of clinically useful biomarkers, I embarked on a journey to discover a novel potential in vivo indicator that would be useful to providers of all specialties who care for septic patients, namely, dysfunctional high-density lipoprotein (Dys-HDL). In my review of the literature I had encountered several studies demonstrating an association between low HDL levels and increased mortality in critically ill patients with sepsis. I had also read that HDL is thought to be protective in sepsis through antioxidant, antiinflammatory and antithrombotic properties. But recent cardiovascular studies had demonstrated that the protective abilities of HDL were dependent on its functional properties. This raised several important questions, which formed the basis of my SCCM-Weil Research Grant. This study was the first to test for the presence of Dys-HDL in patients with sepsis and to attempt to determine whether Dys-HDL levels correlated with Sepsis-Related Organ Failure Assessment (SOFA) scores in early sepsis. My study was designed to enroll 85 patients. I am pleased to report that we have completed enrollment as of March 12, 2017. Preliminary results are quite encouraging as we have demonstrated that Dys-HDL was present in the majority of our septic patients and persistent Dys-HDL elevation was associated with adverse outcomes after sepsis. We have also found some interesting correlations between Dys-HDL and proinflammatory cytokines and significant associations between low HDL levels and mortality, as seen in other studies.
For me, the SCCM-Weil Research Grant was my first substantial extramural grant. I had previously been awarded some institutional grants but none of them were large enough to support this type of prospective, translational work. As an emergency physician applying to a critical care society for funding, I really didn’t believe I would be competitive for this award. But I was wrong. With SCCM, my translational sepsis research finally had a home.
To say that getting this grant was a springboard to other opportunities is an understatement. I cannot emphasize how important this award has been to my overall career and research progress. In addition to performing the work set out in the aims of the study, samples taken from my patients have been used to inform future studies and gain a better understanding of HDL function in sepsis. Preliminary data from my study was also used in a grant application to the National Institutes of Health, for which I was recently funded both a KL2 and a K23 research career development award. Because of my SCCM-Weil Research Grant, I have funding through 2020 to continue my sepsis research.
I am excited about what the future may hold for this line of work and for my own future as a translational sepsis researcher. I would like to thank SCCM for the amazing opportunity of being awarded the SCCM-Weil Grant, which has opened up a world of opportunities and will hopefully lead to new discoveries that will improve care for patients with sepsis.