Advances and Challenges in Sepsis Management: Modern Tools and Future Directions

Author:

Santacroce Elena1,D’Angerio Miriam1,Ciobanu Alin Liviu1ORCID,Masini Linda1,Lo Tartaro Domenico1ORCID,Coloretti Irene2,Busani Stefano2ORCID,Rubio Ignacio3ORCID,Meschiari Marianna2ORCID,Franceschini Erica2ORCID,Mussini Cristina2,Girardis Massimo2ORCID,Gibellini Lara1ORCID,Cossarizza Andrea1ORCID,De Biasi Sara1

Affiliation:

1. Department of Medical and Surgical Sciences for Children & Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy

2. Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy

3. Department of Anesthesiology and Intensive Care Medicine, Center for Sepsis Control and Care, Jena University Hospital, 07747 Jena, Germany

Abstract

Sepsis, a critical condition marked by systemic inflammation, profoundly impacts both innate and adaptive immunity, often resulting in lymphopenia. This immune alteration can spare regulatory T cells (Tregs) but significantly affects other lymphocyte subsets, leading to diminished effector functions, altered cytokine profiles, and metabolic changes. The complexity of sepsis stems not only from its pathophysiology but also from the heterogeneity of patient responses, posing significant challenges in developing universally effective therapies. This review emphasizes the importance of phenotyping in sepsis to enhance patient-specific diagnostic and therapeutic strategies. Phenotyping immune cells, which categorizes patients based on clinical and immunological characteristics, is pivotal for tailoring treatment approaches. Flow cytometry emerges as a crucial tool in this endeavor, offering rapid, low cost and detailed analysis of immune cell populations and their functional states. Indeed, this technology facilitates the understanding of immune dysfunctions in sepsis and contributes to the identification of novel biomarkers. Our review underscores the potential of integrating flow cytometry with omics data, machine learning and clinical observations to refine sepsis management, highlighting the shift towards personalized medicine in critical care. This approach could lead to more precise interventions, improving outcomes in this heterogeneously affected patient population.

Publisher

MDPI AG

Reference329 articles.

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