Sepsis-induced immunosuppression:mechanisms,diagnosis and current treatment options

• Published in: 军事医学研究（英文版） Vol. 10; no. 2; pp. 242 - 261
• Main Authors: Di Liu, Si-Yuan Huang, Jian-Hui Sun, Hua-Cai Zhang, Qing-Li Cai, Chu Gao, Li Li, Ju Cao, Fang Xu, Yong Zhou, Cha-Xiang Guan, Sheng-Wei Jin, Jin Deng, Xiang-Ming Fang, Jian-Xin Jiang, Ling Zeng
• Format: Journal Article
• Language: English
• Published: Department of Trauma Medical Center,Daping Hospital,State Key Laboratory of Trauma,Burns and Combined Injury,Army Medical University,Chongqing 400042,China%Department of Respiratory Disease,Daping Hospital,Army Medical University,Chongqing 400042,China%Department of Laboratory Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China%Department of Critical Care Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China%Department of Physiology,School of Basic Medicine Science,Central South University,Changsha 410078,China%Department of Anesthesia and Critical Care,the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University,Wenzhou 325027,Zhejiang,China%Department of Emergency,the Affiliated Hospital of Guizhou Medical University,Guizhou Medical University,Guiyang 550001,China%Department of Anesthesiology,the First Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310052,China 2023
• Subjects: Immunosuppression; Immune monitoring; Sepsis; Immunomodulatory therapy
• ISSN: 2095-7467

Sepsis is a common complication of combat injuries and trauma,and is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection.It is also one of the significant causes of death and increased health care costs in modern intensive care units.The use of antibiotics,fluid resuscitation,and organ support therapy have limited prognostic impact in patients with sepsis.Although its pathophysiology remains elusive,immunosuppression is now recognized as one of the major causes of septic death.Sepsis-induced immunosuppression is resulted from disruption of immune homeostasis.It is characterized by the release of anti-inflammatory cytokines,abnormal death of immune effector cells,hyperproliferation of immune suppressor cells,and expression of immune checkpoints.By targeting immunosuppression,especially with immune checkpoint inhibitors,preclinical studies have demonstrated the reversal of immunocyte dysfunctions and established host resistance.Here,we comprehensively discuss recent findings on the mechanisms,regulation and biomarkers of sepsis-induced immunosuppression and highlight their implications for developing effective strategies to treat patients with septic shock.