A world-renowned physician-scientist who has dedicated his career to studying the inflammatory response and how it can go awry, Dr. Tracey is head of the Susan and Herman Merinoff Center for Patient-Oriented Research at the Institute for Medical Research of the North Shore-Long Island Jewish Health System in Manhasset, NY. He has been credited with initiating a new field of investigation based on therapeutically targeting systemic inflammation. He first outlined his breakthrough work, called "The Inflammatory Reflex," in a January 2003 Nature article (published online in December 2002).
While training to be a neurosurgeon 20 years ago, Dr. Tracey had no idea how dramatically the course of his life would change when a severely burned baby girl was admitted under his care. The infant developed severe sepsis, which ultimately took her life a month later. After the most dramatic physical and emotional roller-coaster ride of Dr. Tracey's life, the recurring nightmares of her death began, and so did his passion to find out what killed her.
He immediately began researching the syndrome and in the process launched his career in biomedical research. Severe sepsis begins when the body's natural immune response to an insult or infection gets so out of control that it starts to impair the functioning of major organs, often leading to multiple organ failure and death. The syndrome is serious, taking the lives of about a third of those afflicted with it. A normal immune response is a carefully orchestrated battle inside the body fought with precise weapons that target the invaders and prevent their spread. In severe sepsis, for reasons that are still poorly known, the controls break down and the attack goes awry, unleashing the immune weapons in amounts that injure and kill surrounding normal cells in the body's organs, like collateral damage among civilians in guerilla warfare.
Dr. Tracey and his team discovered that the brain, via the vagus nerve -- the largest nerve in the body that wanders through the major organs -- exerts a braking force on the immune system's weapons. This is the inflammatory reflex. They found that by targeting the nervous system, they could control the immune system's inflammatory response.
In Fatal Sequence, Dr. Tracey describes these events in detail within the context of the child's illness and shows how the brain and nervous system play a key role in the development of severe sepsis. He then goes on to discuss new treatments he and collaborators have been developing to combat the deadly syndrome. Offering critical information, Fatal Sequence is a must-read for both the medical community and the public.
**Review copies are available. Please contact Christina Verni at cverni@nshs.edu.**
Fatal Sequence: The Killer Within by Kevin J. Tracey, MD
Dana Press, Washington, DC
March 30, 2005
225 pages; $23.95
ISBN 1-932594-06-X