Advances in Immune Monitoring Approaches for Sepsis-Induced Immunosuppression

Abstract

Sepsis represents a life-threatening organ dysfunction due to an aberrant host response. Of note is that majority of patients have experienced a severe immune depression during and after sepsis, which is significantly correlated with the occurrence of nosocomial infection and higher risk of in-hospital death. Nevertheless, the clinical sign of sepsis-induced immune paralysis remains highly indetectable and ambiguous. Given that, specific yet robust biomarkers for monitoring the immune functional status of septic patients are of prominent significance in clinical practice. In turn, the stratification of a subgroup of septic patients with an immunosuppressive state will greatly contribute to the implementation of personalized adjuvant immunotherapy. In this review, we comprehensively summarize the mechanism of sepsis-associated immunosuppression at the cellular level and highlight the recent advances in immune monitoring approaches targeting the functional status of both innate and adaptive immune responses.

Single-cell transcriptome profiling of the immune space-time landscape reveals dendritic cell regulatory program in polymicrobial sepsis

“…Sepsis is characterized by life-threatening organ dysfunction due to a dysregulated host response to infection based on the definition of Sepsis 3.0. In fact, sepsis remains the leading cause of mortality for patients admitted to intensive care units (ICUs) 1 , 2 . With its incidence increasing worldwide, sepsis results in immense economic and societal costs annually 3 , 4 .…”

Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression

“…Evidence Emerged evidence has demonstrated that immunosuppression can occur at any time after the onset of sepsis [ 11 , 16 , 91 ]. It is inappropriate to blindly conduct immunomodulatory therapy in patients with sepsis, and it is extremely important to identify the starting point for immunomodulatory therapy.…”

Multisite Metagenomic Next-Generation Sequencing Improved Diagnostic Performance for Sepsis-Associated Lymphopenia Patients

“…Sepsis is a major issue in the management of critically ill patients and is associated with high mortality rates. Studies in recent years have shown that many septic patients develop persistent and profound immunosuppression ( 7 to 9 ), and previous studies also indicated that a persistently low level of circulating lymphocytes following a diagnosis of sepsis independently predicts mortality and may serve as a biomarker for sepsis-induced immunosuppression ( 10 , 11 ).…”

“…To improve the efficiency and accuracy of diagnoses based on mNGS in this study, we assessed the significance of multisite mNGS detection on pathogen identification. To our knowledge, this was the first study to describe the application of multisite mNGS for sepsis patients and to evaluate its diagnostic performance in combination with lymphocyte subgroup analysis, which has become a fundamental method for immune monitoring of sepsis cases ( 9 ). We demonstrated that, based on plasma mNGS, additional mNGS sampling of the clinically suspected sites may improve the clinical significance of the results; on the other hand, for patients with distinct lymphopenia, especially decreased CD4 + T lymphocytes, plasma mNGS may provide a more reliable identification of pathogenic microorganisms.…”