第46回日本集中治療医学会学術集会

講演情報

Meet the Experts

[ME3] Meet the Experts3

敗血症性DICの診断・治療のこれから~van der Poll先生と語る
1. そもそも敗血症性DICに抗凝固療法は期待できるのか?
2. トロンボモジュリン試験がうまくいかなかった理由はどこにあるのか?
3. 将来アンチトロンビンで臨床試験を実施する際に注意すべきことは何か?

2019年3月2日(土) 17:05 〜 18:05 第5会場 (国立京都国際会館1F Room D)

座長:射場 敏明(順天堂大学医学部附属 順天堂医院救急・災害医学)

共催:日本製薬株式会社

[ME3-1] The coagulation system in sepsis and the application of anticoagulant therapy

Thomas van der Poll (Amsterdam University Medical Centers, University of Amsterdam, Netherlands)

同時通訳付き】

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Curriculum vitae (September 2018)

Name Tom van der Poll
Date of birth March 20, 1961
Nationality Dutch
Sex Male

Current and recent positions

12/2016 Chair, Department of Medicine, Academic Medical Center, University of Amsterdam, the Netherlands.

01/2011 – 12/2016 Head, Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, the Netherlands.

01/2007 – 12/2016 Head, Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, the Netherlands.

03/2003 Professor of Medicine, University of Amsterdam, the Netherlands.

Education and experience

Board Certified Infectious Diseases May 15, 2000

Board Certified Internal Medicine December 15, 1991
Resident Internal Medicine 1986 – 1991, Academic Medical Center, Amsterdam, the Netherlands

PhD title October 10, 1991 [University of Amsterdam]
Thesis: "Tumor necrosis factor: biologi¬cal responses in humans"

Medical degree November 1986
Medical School, University of Amsterdam 1978 – 1986
Registration (BIG) number: 19023304301

Other activities
• Council member and past Chair of the International Sepsis Forum
• Supervisor (“Promoter”) of 64 succesfully completed PhD projects
• Principal Investigator of > 50 research grants
• Member of advisory boards and steering committees of several pharmaceutical companies
• Member of Data Safety Monitoring Boards and Clinical Evaluation Committees of several trials on sepsis, pneumonia and rheumatoid arthritis

Web of Science report:
911 publications; 39,371 citations; 4,223 times in 2017
Hirsch index 98

Selected publications (most recent 10 years)

1. Scicluna B.P., van Vught L.A., Zwinderman A.H., Wiewel M.A., Davenport E.E., Burnham K.L., Nürnberg P., Schultz M.J., Horn J., Cremer O.L., Bonten M.J., Hinds C.J., Wong H.R., Knight J.C., van der Poll T. Classification of sepsis patients as blood genomic endotypes: a prospective cohort study. Lancet Respiratory Medicine 2017; 5: 816-826.
2. Van der Poll T., van de Veerdonk F.L., Scicluna B.S., Netea M.G. The immunopathology of sepsis and potential therapeutic targets. Nature Reviews Immunology 2017; 17(7):407-420.
3. Van Vught L.A., Wiewel M.A., Hoogendijk A.J., Frencken J.F., Scicluna B.P., Klein Klouwenberg P.M., Zwinderman A.H., Lutter R., Horn J., Schultz M.J., Bonten M.M., Cremer O.L., van der Poll T. The host response in sepsis patients developing Intensive Care Unit-acquired secondary infections. Am. J. Respir. Crit. Care Med. 2017; 196: 458-470.
4. Van Vught L.A., Klein Klouwenberg P.M.C., Spitoni C., Scicluna B.P., Wiewel M.A., Horn J., Schultz M.J., Nürnberg P., Bonten M.J.M, Cremer O.L., van der Poll T; on behalf of the MARS consortium. Incidence, risk factors and attributable mortality of secondary infections in the intensive care unit after admission for sepsis. JAMA 2016; 315: 1469-79.
5. van Vught L.A., Scicluna B.P., Wiewel M.A., Hoogendijk A.J., Klein Klouwenberg P.M., Franitza M., Toliat M.R., Nürnberg P., Cremer O.L., Horn J., Schultz M.J., Bonten M.M., van der Poll T. Comparative analysis of the host response to community-acquired and hospital-acquired pneumonia in critically ill patients. Am. J. Respir. Crit. Care Med. 2016; 194:1366-1374.
6. Claushuis T.A., van Vught L.A., Scicluna B.P., Wiewel M.A., Klein Klouwenberg P.M., Hoogendijk A.J., Ong D.S., Cremer O.L., Horn J., Franitza M., Toliat M.R., Nürnberg P., Zwinderman A.H., Bonten M.J., Schultz M.J., van der Poll T.; MARS Consortium. Thrombocytopenia is associated with a dysregulated host response in critically ill sepsis patients. Blood 2016; 127: 3062-72.
7. Cheng S.C., Scicluna B.P., Arts R.J.W., Gresnigt M.S., Lachmandas E., Giamarellos-Bourboulis E.J., Kox M., Manjeri G.R., Wagenaars J., Cremer O.L., Leentjens J., van der Meer A.J., van de Veerdonk F., Bonten M.J., Schultz M.J., Willems P., Pickkers P., Joosten L.A.B., van der Poll T.*, Netea M.G.* (*shared senior authorship). Broad defects in energy metabolism of leukocytes underlie immunoparalysis in sepsis. Nature Immunology 2016; 17: 406-13.
8. Scicluna B.P., Klein Klouwenberg P.M., van Vught L.A., Wiewel M.A., Ong D.S., Zwinderman A.H., Franitza M., Toliat M.R., Nürnberg P., Hoogendijk A.J., Horn J., Cremer O.L., Schultz M.J., Bonten M.J., van der Poll T. A Molecular biomarker to diagnose community-acquired pneumonia on Intensive Care Unit admission. Am. J. Respir. Crit. Care Med. 2015; 192:826-835.
9. Huson M.A.M., Grobusch M.P., van der Poll T. The impact of HIV infection on the host response to bacterial sepsis. Lancet Infect. Dis. 2015; 15(1):95-108.
10. De Stoppelaar S.F., van 't Veer C., Claushuis T.A., Albersen B.J., Roelofs J.J., van der Poll T. . Thrombocytopenia impairs host defense in gram-negative pneumonia-derived sepsis in mice. Blood 2014; 124: 3781-3790
11. Angus D.C., van der Poll T. Severe sepsis and septic shock. N. Engl. J. Med. 2013; 369: 840-851.
12. Van der Poll T., Opal S.M. The pathogenesis, treatment and prevention of pneumococcal pneumonia. Lancet 2009; 374: 1543-1556.
13. Van ’t Veer C., van der Poll T. Keeping blood clots at bay in sepsis. Nature Med. 2008; 14: 606-608.
14. Van der Poll T., Opal S.M. Host-pathogen interactions in sepsis. Lancet Infect. Dis. 2008: 8: 32-43.
15. Wiersinga W.J., Wieland C.W., Dessing M.C., Chantratita N., Cheng A.C., Limmathurotsakul D., Chierakul W., Leendertse M., Florquin S., de Vos A.F., White N., Dondorp A.M., Day N.P., Peacock S.J., van der Poll T. Toll-like receptor 2 impairs host defense in gram-negative sepsis caused by Burkholderia pseudomallei (melioidosis). PLoS Medicine 2007; 4: e248.

Bibliography
Tom van der Poll is Professor of Medicine and Chair of the Department of Medicine in the Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam, the Netherlands. Van der Poll is board certified in Internal Medicine and Infectious Diseases. His training included a postdoctoral research fellowship in Cornell University Medical College in New York (1993-1995). Van der Poll’s research focuses on pneumonia and sepsis, particularly on pathogenesis, the host response and biomarkers. He published > 800 articles on this topic. Van der Poll has served as a member of Data Safety and Clinical Monitoring Boards of several pivotal phase III sepsis and pneumonia trials evaluating immunomodulatory agents.
Activation in coagulation is a part of the innate immune system and it has been found to play an important role in the early host response to infection. However, when systemically activated, coagulation can cause serious complications associated with high morbidity and mortality. As such, activation of coagulation in response to an infection represents a delicate balance between beneficial host protective and potentially detrimental effects. Thus, the application of the anticoagulant therapy for sepsis patients should be considered carefully.