Therapeutic Approaches in Modulating the Inflammatory and Immunological Response in Patients With Sepsis, Acute Respiratory Distress Syndrome, and Pancreatitis: An Expert Opinion Review

Immune dysfunction is common in critically ill patients who are more vulnerable to infections and the systemic consequences of dysfunctional defense responses. Immune dysfunction directly affects patient morbidity and mortality [1-3]. Critically ill patients respond differently to the injury. The response may be characterized by either pronounced inflammatory reaction or injury-related immunosuppression [2,4]. The exaggerated immune response is primarily due to the release of proinflammatory cytokines, often referred to as cytokine storm, which is common in critically ill patients with infections or injuries (e.g., sepsis, acute respiratory distress syndrome [ARDS]) [5]. Even in patients with acute pancreatitis (AP), the early systemic inflammatory response is associated with severe disease, and systemic inflammation and organ failure depict the same mechanisms observed in sepsis and ARDS [6,7]. The progression of dysregulated immune response along with infection, inflammation, ischemia, and/or shock leads to multiorgan dysfunction