IMMUNOLOGICAL FEATURES OF SEPSIS PHENOTYPES AND ENDOTYPES

AbstractSepsis is a heterogeneous and life-threatening condition caused by a dysregulated immune response to infection. The most severe form of sepsis is septic shock, characterized by arterial hypotension, impaired tissue perfusion, and hypoxia. Despite new findings in antimicrobial and intensive c...

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Main Authors: Mariia B. Potapova, Vitaly V. Zverev, Maxim A. Babaev, Ekaterina A. Bogdanova, Oksana O. Grin, Irina B. Semenova, Ekaterina A. Meremianina, Oxana A. Svitich
Format: Article
Language:Russian
Published: St. Petersburg branch of the Russian Association of Allergologists and Clinical Immunologists 2019-08-01
Series:Медицинская иммунология
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Online Access:https://www.mimmun.ru/mimmun/article/view/3254
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author Mariia B. Potapova
Vitaly V. Zverev
Maxim A. Babaev
Ekaterina A. Bogdanova
Oksana O. Grin
Irina B. Semenova
Ekaterina A. Meremianina
Oxana A. Svitich
author_facet Mariia B. Potapova
Vitaly V. Zverev
Maxim A. Babaev
Ekaterina A. Bogdanova
Oksana O. Grin
Irina B. Semenova
Ekaterina A. Meremianina
Oxana A. Svitich
author_sort Mariia B. Potapova
collection DOAJ
description AbstractSepsis is a heterogeneous and life-threatening condition caused by a dysregulated immune response to infection. The most severe form of sepsis is septic shock, characterized by arterial hypotension, impaired tissue perfusion, and hypoxia. Despite new findings in antimicrobial and intensive care therapy, the incidence and mortality rates of sepsis remain high, which underscores the relevance of further investigation of its pathogenesis. In recent years, research has shifted from clinical signs to the analysis of immunological and molecular mechanisms, which has led to the identification of  specific phenotypes and endotypes of the disease. Sepsis phenotypes are based on clinical manifestations and biomarkers, while endotypes are defined by molecular mechanisms, including immune gene expression patterns.This article reviews key aspects of the innate and adaptive immune responses in sepsis, including the activation of proinflammatory cytokines, the development of coagulopathies, and disruptions of endothelial integrity and microvascular regulation.Moreover, the importance of mechanisms such as hyperinflammation, the simultaneous development of immunosuppression and functional exhaustion of immunocompetent cells is emphasized. Thus, immunological biomarkers are considered as a promising tool for patient‘s stratification, prognosis prediction and personalized therapy. Current immunodiagnostic methods are also considered in this article, including quantitative analysis of cytokine levels and assessment of innate immune dysfunction markers.Thus, the current understanding of sepsis as an immunologically heterogeneous syndrome enables researchers to expand existing concepts of its pathogenesis. In contrast to the classical concept which is based on a shift from inflammation to immunosuppression, increasing data highlights the simultaneous presence of both processes in the same patient, making it necessary to reconsider existing diagnostic and therapeutic approaches.
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language Russian
publishDate 2019-08-01
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spelling doaj-art-1b0b18fbd3f64eb89a4caf70521f50082025-08-20T04:00:27ZrusSt. Petersburg branch of the Russian Association of Allergologists and Clinical ImmunologistsМедицинская иммунология1563-06252313-741X2019-08-010010.15789/1563-0625-IFO-32542063IMMUNOLOGICAL FEATURES OF SEPSIS PHENOTYPES AND ENDOTYPESMariia B. Potapova0Vitaly V. Zverev1Maxim A. Babaev2Ekaterina A. Bogdanova3Oksana O. Grin4Irina B. Semenova5Ekaterina A. Meremianina6Oxana A. Svitich7I.I. Mechnikov Research Institute for Vaccines and SeraI.I. Mechnikov Research Institute for Vaccines and Sera; I.M. Sechenov First Moscow State Medical University (Sechenov University)B.V. Petrovsky Russian Research Center for SurgeryI.M. Sechenov First Moscow State Medical University (Sechenov University)B.V. Petrovsky Russian Research Center for SurgeryI.I. Mechnikov Research Institute for Vaccines and SeraI.I. Mechnikov Research Institute for Vaccines and SeraI.I. Mechnikov Research Institute for Vaccines and Sera; I.M. Sechenov First Moscow State Medical University (Sechenov University)AbstractSepsis is a heterogeneous and life-threatening condition caused by a dysregulated immune response to infection. The most severe form of sepsis is septic shock, characterized by arterial hypotension, impaired tissue perfusion, and hypoxia. Despite new findings in antimicrobial and intensive care therapy, the incidence and mortality rates of sepsis remain high, which underscores the relevance of further investigation of its pathogenesis. In recent years, research has shifted from clinical signs to the analysis of immunological and molecular mechanisms, which has led to the identification of  specific phenotypes and endotypes of the disease. Sepsis phenotypes are based on clinical manifestations and biomarkers, while endotypes are defined by molecular mechanisms, including immune gene expression patterns.This article reviews key aspects of the innate and adaptive immune responses in sepsis, including the activation of proinflammatory cytokines, the development of coagulopathies, and disruptions of endothelial integrity and microvascular regulation.Moreover, the importance of mechanisms such as hyperinflammation, the simultaneous development of immunosuppression and functional exhaustion of immunocompetent cells is emphasized. Thus, immunological biomarkers are considered as a promising tool for patient‘s stratification, prognosis prediction and personalized therapy. Current immunodiagnostic methods are also considered in this article, including quantitative analysis of cytokine levels and assessment of innate immune dysfunction markers.Thus, the current understanding of sepsis as an immunologically heterogeneous syndrome enables researchers to expand existing concepts of its pathogenesis. In contrast to the classical concept which is based on a shift from inflammation to immunosuppression, increasing data highlights the simultaneous presence of both processes in the same patient, making it necessary to reconsider existing diagnostic and therapeutic approaches.https://www.mimmun.ru/mimmun/article/view/3254sepsis, sepsis endotypes, sepsis phenotypes, immune dysfunction, biomarkers
spellingShingle Mariia B. Potapova
Vitaly V. Zverev
Maxim A. Babaev
Ekaterina A. Bogdanova
Oksana O. Grin
Irina B. Semenova
Ekaterina A. Meremianina
Oxana A. Svitich
IMMUNOLOGICAL FEATURES OF SEPSIS PHENOTYPES AND ENDOTYPES
Медицинская иммунология
sepsis, sepsis endotypes, sepsis phenotypes, immune dysfunction, biomarkers
title IMMUNOLOGICAL FEATURES OF SEPSIS PHENOTYPES AND ENDOTYPES
title_full IMMUNOLOGICAL FEATURES OF SEPSIS PHENOTYPES AND ENDOTYPES
title_fullStr IMMUNOLOGICAL FEATURES OF SEPSIS PHENOTYPES AND ENDOTYPES
title_full_unstemmed IMMUNOLOGICAL FEATURES OF SEPSIS PHENOTYPES AND ENDOTYPES
title_short IMMUNOLOGICAL FEATURES OF SEPSIS PHENOTYPES AND ENDOTYPES
title_sort immunological features of sepsis phenotypes and endotypes
topic sepsis, sepsis endotypes, sepsis phenotypes, immune dysfunction, biomarkers
url https://www.mimmun.ru/mimmun/article/view/3254
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AT maximababaev immunologicalfeaturesofsepsisphenotypesandendotypes
AT ekaterinaabogdanova immunologicalfeaturesofsepsisphenotypesandendotypes
AT oksanaogrin immunologicalfeaturesofsepsisphenotypesandendotypes
AT irinabsemenova immunologicalfeaturesofsepsisphenotypesandendotypes
AT ekaterinaameremianina immunologicalfeaturesofsepsisphenotypesandendotypes
AT oxanaasvitich immunologicalfeaturesofsepsisphenotypesandendotypes