TY - JOUR
T1 - Sepsis-Induced Immunosuppression
AU - Torres, Lisa K.
AU - Pickkers, Peter
AU - van der Poll, Tom
N1 - Publisher Copyright: © 2022 Annual Reviews Inc.. All rights reserved.
PY - 2022
Y1 - 2022
N2 - Sepsis is expected to have a substantial impact on public health and cost as its prevalence increases. Factors contributing to increased prevalence include a progressively aging population, advances in the use of immunomodulatory agents to treat a rising number of diseases, and immune-suppressing therapies in organ transplant recipients and cancer patients. It is now recognized that sepsis is associated with profound and sustained immunosuppression, which has been implicated as a predisposing factor in the increased susceptibility of patients to secondary infections and mortality. In this review, we discuss mechanisms of sepsis-induced immunosuppression and biomarkers that identify a state of impaired immunity. We also highlight immune-enhancing strategies that have been evaluated in patients with sepsis, as well as therapeutics under current investigation. Finally, we describe future challenges and the need for a new treatment paradigm, integrating predictive enrichment with patient factors that may guide the future selection of tailored immunotherapy.
AB - Sepsis is expected to have a substantial impact on public health and cost as its prevalence increases. Factors contributing to increased prevalence include a progressively aging population, advances in the use of immunomodulatory agents to treat a rising number of diseases, and immune-suppressing therapies in organ transplant recipients and cancer patients. It is now recognized that sepsis is associated with profound and sustained immunosuppression, which has been implicated as a predisposing factor in the increased susceptibility of patients to secondary infections and mortality. In this review, we discuss mechanisms of sepsis-induced immunosuppression and biomarkers that identify a state of impaired immunity. We also highlight immune-enhancing strategies that have been evaluated in patients with sepsis, as well as therapeutics under current investigation. Finally, we describe future challenges and the need for a new treatment paradigm, integrating predictive enrichment with patient factors that may guide the future selection of tailored immunotherapy.
UR - http://www.scopus.com/inward/record.url?scp=85121631690&partnerID=8YFLogxK
U2 - https://doi.org/10.1146/annurev-physiol-061121-040214
DO - https://doi.org/10.1146/annurev-physiol-061121-040214
M3 - Review article
C2 - 34705481
SN - 0066-4278
VL - 84
SP - 157
EP - 181
JO - Annual review of physiology
JF - Annual review of physiology
ER -