Kolodyazhna Aryna, Wiersinga W Joost, van der Poll Tom
Amsterdam University Medical Center, University of Amsterdam, Center of Experimental and Molecular Medicine & Division of Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam, the Netherlands.
Burns Trauma. 2025 Jan 3;13:tkae073. doi: 10.1093/burnst/tkae073. eCollection 2025.
According to the latest definition, sepsis is characterized by life-threatening organ dysfunction caused by a dysregulated host response to an infection. However, this definition fails to grasp the heterogeneous nature and the underlying dynamic pathophysiology of the syndrome. In response to this heterogeneity, efforts have been made to stratify sepsis patients into subtypes, either based on their clinical presentation or pathophysiological characteristics. Subtyping introduces the possibility of the implementation of personalized medicine, whereby each patient receives treatment tailored to their individual disease manifestation. This review explores the currently known subtypes, categorized by subphenotypes and endotypes, as well as the treatments that have been researched thus far in the context of sepsis subtypes and personalized medicine.
根据最新定义,脓毒症的特征是宿主对感染的反应失调导致危及生命的器官功能障碍。然而,这一定义未能把握该综合征的异质性本质及其潜在的动态病理生理学。针对这种异质性,人们已努力将脓毒症患者分为不同亚型,要么基于其临床表现,要么基于病理生理特征。亚型分类为实施个性化医疗带来了可能性,即每位患者都接受针对其个体疾病表现量身定制的治疗。本综述探讨了目前已知的亚型,按亚表型和内型进行分类,以及迄今为止在脓毒症亚型和个性化医疗背景下所研究的治疗方法。