Amsterdam University Medical Centers, University of Amsterdam, Center of Experimental and Molecular Medicine & Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.
King's College London, Department of Infectious Diseases, School of Immunology and Microbial Sciences, London, UK; Guy's and St Thomas' NHS Foundation Trust, Department of Intensive Care Medicine, London, UK.
Immunity. 2021 Nov 9;54(11):2450-2464. doi: 10.1016/j.immuni.2021.10.012.
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to an infection. This recently implemented definition does not capture the heterogeneity or the underlying pathophysiology of the syndrome, which is characterized by concurrent unbalanced hyperinflammation and immune suppression. Here, we review current knowledge of aberrant immune responses during sepsis and recent initiatives to stratify patients with sepsis into subgroups that are more alike from a clinical and/or pathobiological perspective, which could be key for identification of patients who are more likely to benefit from specific immune interventions.
脓毒症定义为感染引起的宿主失调反应导致的危及生命的器官功能障碍。这一最近实施的定义并未捕捉到该综合征的异质性或潜在病理生理学,其特征是同时存在失衡的过度炎症和免疫抑制。在此,我们综述脓毒症期间异常免疫反应的现有知识,并探讨最近将脓毒症患者分层为具有相似临床和/或病理生物学特征亚组的举措,这可能是确定更有可能从特定免疫干预中获益的患者的关键。