Reframing sepsis immunobiology for translation : towards informative subtyping and targeted immunomodulatory therapies

Copyright © 2024 Elsevier Ltd. All rights reserved..

Sepsis is a common and deadly condition. Within the current model of sepsis immunobiology, the framing of dysregulated host immune responses into proinflammatory and immunosuppressive responses for the testing of novel treatments has not resulted in successful immunomodulatory therapies. Thus, the recent focus has been to parse observable heterogeneity into subtypes of sepsis to enable personalised immunomodulation. In this Personal View, we highlight that many fundamental immunological concepts such as resistance, disease tolerance, resilience, resolution, and repair are not incorporated into the current sepsis immunobiology model. The focus for addressing heterogeneity in sepsis should be broadened beyond subtyping to encompass the identification of deterministic molecular networks or dominant mechanisms. We explicitly reframe the dysregulated host immune responses in sepsis as altered homoeostasis with pathological disruption of immune-driven resistance, disease tolerance, resilience, and resolution mechanisms. Our proposal highlights opportunities to identify novel treatment targets and could enable successful immunomodulation in the future.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:12

Enthalten in:

The Lancet. Respiratory medicine - 12(2024), 4 vom: 24. Apr., Seite 323-336

Sprache:

Englisch

Beteiligte Personen:

Shankar-Hari, Manu [VerfasserIn]
Calandra, Thierry [VerfasserIn]
Soares, Miguel P [VerfasserIn]
Bauer, Michael [VerfasserIn]
Wiersinga, W Joost [VerfasserIn]
Prescott, Hallie C [VerfasserIn]
Knight, Julian C [VerfasserIn]
Baillie, Kenneth J [VerfasserIn]
Bos, Lieuwe D J [VerfasserIn]
Derde, Lennie P G [VerfasserIn]
Finfer, Simon [VerfasserIn]
Hotchkiss, Richard S [VerfasserIn]
Marshall, John [VerfasserIn]
Openshaw, Peter J M [VerfasserIn]
Seymour, Christopher W [VerfasserIn]
Venet, Fabienne [VerfasserIn]
Vincent, Jean-Louis [VerfasserIn]
Le Tourneau, Christophe [VerfasserIn]
Maitland-van der Zee, Anke H [VerfasserIn]
McInnes, Iain B [VerfasserIn]
van der Poll, Tom [VerfasserIn]

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Journal Article
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Anmerkungen:

Date Completed 01.04.2024

Date Revised 25.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/S2213-2600(23)00468-X

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368984265