Immune homeostasis (deregulation) in sepsis and septic shock

Authors: Karvunidis Thomas 1;  Lysák Daniel 2;  Chvojka Jiří 1;  Ledvinová Lenka 1;  Raděj Jaroslav 1;  Novák Ivan 1;  Matějovič Martin 1
Authors‘ workplace: JIP, I. interní klinika FN v Plzni a LF v Plzni, Univerzita Karlova v Praze 1;  Hematologicko-onkologické oddělení, Fakultní nemocnice v Plzni 2
Published in: Anest. intenziv. Med., 24, 2013, č. 4, s. 250-263
Category: Intensive Care Medicine - Original Paper


Sepsis and septic shock represent an important medical and socio-economic burden worldwide. The double-phased concept of significant immune homeostasis impairment in sepsis has generally been accepted. In this theory, the initial phase is characterized by enormous activation of immune system followed by the compen-satory phase resulting in profound immunosuppression. However, this paradigm has recently been challenged and the concept of simultaneous pro-inflammatory, anti-inflammatory and adaptive immunity suppressing response occurring early in sepsis has been introduced. These immune alterations leading to the failure to combat relatively avirulent, nosocomial and opportune pathogens, and prolonged multiorgan dysfunction seem to be a major cause of increased morbidity and mortality in critically ill patients. This review briefly summarizes the current concept of sepsis-induced immune deregulation and discusses diagnostic tools and emerging immune-based therapeutic interventions.

sepsis – immune response – immune deregulation – flow cytometry


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