Profiling the dysregulated immune response in sepsis: overcoming challenges to achieve the goal of precision medicine

Sara Cajander, Matthijs Kox, Brendon P Scicluna, Markus A Weigand, Raquel Almansa Mora, Stefanie B Flohé, Ignacio Martin-Loeches, Gunnar Lachmann, Massimo Girardis, Alberto Garcia-Salido, Frank M Brunkhorst, Michael Bauer, Antoni Torres, Andrea Cossarizza, Guillaume Monneret, Jean-Marc Cavaillon, Manu Shankar-Hari, Evangelos J Giamarellos-Bourboulis, Martin Sebastian Winkler, Tomasz SkireckiMarcin Osuchowski, Ignacio Rubio, Jesus F Bermejo-Martin, Joerg C Schefold, Fabienne Venet

Research output: Contribution to journalReview articlepeer-review

Abstract

Sepsis is characterised by a dysregulated host immune response to infection. Despite recognition of its significance, immune status monitoring is not implemented in clinical practice due in part to the current absence of direct therapeutic implications. Technological advances in immunological profiling could enhance our understanding of immune dysregulation and facilitate integration into clinical practice. In this Review, we provide an overview of the current state of immune profiling in sepsis, including its use, current challenges, and opportunities for progress. We highlight the important role of immunological biomarkers in facilitating predictive enrichment in current and future treatment scenarios. We propose that multiple immune and non-immune-related parameters, including clinical and microbiological data, be integrated into diagnostic and predictive combitypes, with the aid of machine learning and artificial intelligence techniques. These combitypes could form the basis of workable algorithms to guide clinical decisions that make precision medicine in sepsis a reality and improve patient outcomes.

Original languageEnglish
Pages (from-to)305-322
Number of pages18
JournalThe Lancet Respiratory Medicine
Volume12
Issue number4
Early online date21 Dec 2023
DOIs
Publication statusPublished - 1 Apr 2024

Keywords / Materials (for Non-textual outputs)

  • Humans
  • Precision Medicine/methods
  • Artificial Intelligence
  • Goals
  • Algorithms
  • Sepsis/diagnosis

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