Rao Mahil, McGonagill Patrick W, Brackenridge Scott, Remy Kenneth E, Caldwell Charles C, Hotchkiss Richard S, Moldawer Lyle L, Griffith Thomas S, Badovinac Vladimir P
Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa.
Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa.
Shock. 2025 Feb 1;63(2):189-201. doi: 10.1097/SHK.0000000000002511. Epub 2024 Nov 20.
Sepsis remains a significant cause of morbidity and mortality worldwide. Although many more patients are surviving the acute event, a substantial number enters a state of persistent inflammation and immunosuppression, rendering them more vulnerable to infections. Modulating the host immune response has been a focus of sepsis research for the past 50 years, yet novel therapies have been few and far between. Although many septic patients have similar clinical phenotypes, pathways affected by the septic event differ not only between individuals but also within an individual over the course of illness. These differences ultimately impact overall immune function and response to treatment. Defining the immune state, or endotype, of an individual is critical to understanding which patients will respond to a particular therapy. In this review, we highlight current approaches to define the immune endotype and propose that these technologies may be used to "prescreen" individuals to determine which therapies are most likely to be beneficial.
脓毒症仍然是全球发病和死亡的一个重要原因。尽管越来越多的患者在急性事件中存活下来,但仍有相当数量的患者进入持续炎症和免疫抑制状态,使他们更容易受到感染。在过去50年里,调节宿主免疫反应一直是脓毒症研究的重点,但新疗法却寥寥无几。尽管许多脓毒症患者具有相似的临床表型,但脓毒症事件所影响的途径不仅在个体之间存在差异,而且在疾病过程中同一个体内也存在差异。这些差异最终会影响整体免疫功能和对治疗的反应。确定个体的免疫状态或内型对于了解哪些患者会对特定治疗产生反应至关重要。在这篇综述中,我们重点介绍了定义免疫内型的当前方法,并提出这些技术可用于 “预筛选” 个体,以确定哪些疗法最有可能有益。