@article{44abd904d5fa427381f7e36918f1cdc4,
title = "THE EUROPEAN SHOCK SOCIETY MEETS THE IMMUNOSEP CONSORTIUM FOR PERSONALIZED SEPSIS TREATMENT",
abstract = "The unacceptable high mortality of severe infections and sepsis led over the years to understand the need for adjunctive immunotherapy to modulate the dysregulated host response of the host. However, not all patients should receive the same type of treatment. The immune function may largely differ from one patient to the other. The principles of precision medicine require that some biomarker is used to capture the immune function of the host and guide the best candidate therapy. This is the approach of the ImmunoSep randomized clinical trial (NCT04990232) where patients are allocated to treatment with anakinra or recombinant interferon gamma tailored to immune signs of macrophage activation-like syndrome and immunoparalysis respectively. ImmunoSep is a first-in-class paradigm of precision medicine for sepsis. Other approaches need to consider classification by sepsis endotypes, targeting T cell and application of stem cells. Basic principle for any trial to be successful is the delivery of appropriate antimicrobial therapy as standard-of-care taking into consideration not just the likelihood for resistant pathogens but also the pharmacokinetic/pharmacodynamic mode of action of the administered antimicrobial.",
keywords = "Sepsis, T cells, endotypes, immune function, precision medicine, stem cells",
author = "Giamarellos-Bourboulis, {Evangelos J.} and George Dimopoulos and Stefanie Floh{\'e} and Antigoni Kotsaki and {van der Poll}, Tom and Tomasz Skirecki and Antoni Torres and Netea, {Mihai G.}",
note = "Funding Information: Personalized treatment approach in sepsis is the vision of the ImmunoSep project. This study ( Clinicaltrials.gov NCT04990232) is funded by the EU Horizon 2020 program. Eligible patients should have sepsis due to lower respiratory tract infections or primary bacteremia defined by the Sepsis-3 definitions, and immunological evidence of macrophage activation-like syndrome (MALS) or sepsis-induced immunoparalysis. All patients with community-acquired pneumonia (CAP), hospital-acquired pneumonia, and ventilator-associated pneumonia are allowed to participate. Macrophage activation-like syndrome is classified by serum ferritin more than 4,420 ng/mL and sepsis-induced immunoparalysis by absolute human leukocyte antigen DR on circulating CD45/CD14 monocytes less than 5,000/cell for patients with serum ferritin 4,420 ng/mL or less. Participants are randomized using a double-blind, double-dummy design into treatment with standard-of-care (SoC) and personalized immunotherapy or into treatment with SoC and placebo immunotherapy. Patients who are allocated to personalized immunotherapy for MALS are randomized to receive intravenous anakinra for 15 days; those with sepsis-induced immunoparalysis are randomized to receive subcutaneous recombinant human interferon γ. The primary trial endpoint is the change of the mean total sequential organ failure assessment score by day 9 (). Publisher Copyright: {\textcopyright} Wolters Kluwer Health, Inc. All rights reserved.",
year = "2023",
month = mar,
day = "1",
doi = "https://doi.org/10.1097/SHK.0000000000001955",
language = "English",
volume = "59",
pages = "21--25",
journal = "Shock",
issn = "1073-2322",
publisher = "Lippincott Williams and Wilkins",
number = "3",
}