Cells (Mar 2024)

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

  • Elena Santacroce,
  • Miriam D’Angerio,
  • Alin Liviu Ciobanu,
  • Linda Masini,
  • Domenico Lo Tartaro,
  • Irene Coloretti,
  • Stefano Busani,
  • Ignacio Rubio,
  • Marianna Meschiari,
  • Erica Franceschini,
  • Cristina Mussini,
  • Massimo Girardis,
  • Lara Gibellini,
  • Andrea Cossarizza,
  • Sara De Biasi

DOI
https://doi.org/10.3390/cells13050439
Journal volume & issue
Vol. 13, no. 5
p. 439

Abstract

Read online

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.

Keywords