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

被引：72

作者：

Cajander, Sara ^{[1
]}

Kox, Matthijs ^{[2
,3
]}

Scicluna, Brendon P. ^{[4
,5
]}

Weigand, Markus A. ^{[6
]}

Mora, Raquel Almansa ^{[7
]}

Flohe, Stefanie B. ^{[8
]}

Martin-Loeches, Ignacio ^{[9
,10
]}

Lachmann, Gunnar ^{[11
,12
,13
]}

Girardis, Massimo ^{[14
]}

Garcia-Salido, Alberto ^{[15
]}

Brunkhorst, Frank M. ^{[16
]}

Bauer, Michael ^{[17
]}

Torres, Antoni ^{[18
]}

Cossarizza, Andrea ^{[19
]}

Monneret, Guillaume ^{[20
,21
]}

Cavaillon, Jean-Marc ^{[22
]}

Shankar-Hari, Manu ^{[23
]}

Giamarellos-Bourboulis, Evangelos J. ^{[24
]}

Winkler, Martin Sebastian ^{[25
]}

Skirecki, Tomasz ^{[26
]}

Osuchowski, Marcin ^{[27
]}

Rubio, Ignacio ^{[17
]}

Bermejo-Martin, Jesus F. ^{[28
,29
,30
]}

Schefold, Joerg C. ^{[31
]}

Venet, Fabienne ^{[20
,32
,33
]}

机构：

[1] Orebro Univ, Fac Med & Hlth, Dept Infect Dis, Orebro, Sweden

[2] Radboud Univ Nijmegen, Dept Intens Care Med, Med Ctr, Nijmegen, Netherlands

[3] Radboud Univ Nijmegen, Radboud Ctr Infect Dis, Med Ctr, Nijmegen, Netherlands

[4] Univ Malta, Mater Dei Hosp, Dept Appl Biomed Sci, Fac Hlth Sci, Msida, Malta

[5] Univ Malta, Ctr Mol Med & Biobanking, Msida, Malta

[6] Heidelberg Univ Hosp, Dept Anesthesiol, Heidelberg, Germany

[7] Univ Valladolid, Dept Cell Biol Genet Histol & Pharmacol, Valladolid, Spain

[8] Univ Duisburg Essen, Univ Hosp Essen, Dept Trauma Hand & Reconstruct Surg, Essen, Germany

[9] St James Hosp, Dublin, Ireland

[10] Univ Barcelona, Inst Invest Biomed August Pi i Sunyer, Hosp Clin, Barcelona, Spain

[11] Charite Univ Med Berlin, Berlin, Germany

[12] Free Univ Berlin, Berlin, Germany

[13] Humboldt Univ, Dept Anesthesiol & Operat Intens Care Med, Berlin, Germany

[14] Univ Hosp Modena, Dept Intens Care & Anesthesiol, Modena, Italy

[15] Hosp Infantil Univ Nino Jesus, Pediat Crit Care Unit, Madrid, Spain

[16] Jena Univ Hosp, Dept Anesthesiol & Intens Care Med, Jena, Germany

[17] Jena Univ Hosp, Integrated Res & Treatment Ctr, Ctr Sepsis Control & Care, Jena, Germany

[18] Univ Barcelona, Hosp Clin Barcelona, Pulmonol Dept, Ciberes,IDIBAPS,ICREA, Barcelona, Spain

[19] Univ Modena & Reggio Emilia, Dept Med & Surg Sci Children & Adults, Modena, Italy

[20] Hosp Civils Lyon, Immunol Lab, Hop E Herriot, Lyon, France

[21] Univ Claude Bernard Lyon 1, Hop E Herriot, Lyon, France

[22] Inst Pasteur, Paris, France

[23] Univ Edinburgh, Inst Regenerat & Repair, Ctr Inflammat Res, Edinburgh, Scotland

[24] Natl & Kapodistrian Univ Athens, Med Sch, Dept Internal Med 4, Athens, Greece

[25] Dept Anesthesiol & Intens Care, Univ med Gottingen, Gottingen, Germany

[26] Ctr Postgrad Med Educ, Dept Translat Immunol & Expt Intens Care, Warsaw, Poland

[27] Ludwig Boltzmann Inst Traumatol, Res Ctr Cooperat AUVA, Vienna, Austria

[28] Inst Invest Biomed Salamanca, Salamanca, Spain

[29] Univ Salamanca, Sch Med, Salamanca, Spain

[30] Inst Salud Carlos III, Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain

[31] Univ Bern, Bern Univ Hosp, Dept Intens Care Med, Inselspital, Bern, Switzerland

[32] Univ Claude Bernard Lyon 1, Ctr Int Rech Infectiol, Ecole Normale Super Lyon, Inserm U1111,CNRS,UMR5308, Lyon, France

[33] Hosp Civils Lyon, Immunol Lab, Hop E Herriot, F-69437 Lyon, France

来源：

LANCET RESPIRATORY MEDICINE | 2024年 / 12卷 / 04期

关键词：

INTERFERON-GAMMA IMMUNOTHERAPY; COMMUNITY-ACQUIRED PNEUMONIA; SEPTIC SHOCK PATIENTS; REGULATORY T-CELLS; CYTOMEGALOVIRUS REACTIVATION; INFLAMMATORY RESPONSE; HOSPITALIZED-PATIENTS; FRAGMENT AFELIMOMAB; INNATE IMMUNITY; MASS CYTOMETRY;

D O I：

10.1016/S2213-2600(23)00330-2

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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.

引用

页码：305 / 322

页数：18

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