Anest. intenziv. Med. 2013;24(4):250-263

Immune homeostasis (deregulation) in sepsis and septic shockIntensive Care Medicine - Original Paper

Karvunidis Thomas¹, Lysák Daniel², Chvojka Jiří¹, Ledvinová Lenka¹, Raděj Jaroslav¹, Novák Ivan¹, Matějovič Martin^1,*

¹ JIP, I. interní klinika FN v Plzni a LF v Plzni, Univerzita Karlova v Praze

² Hematologicko-onkologické oddělení, Fakultní nemocnice v Plzni

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.

Keywords: sepsis; immune response; immune deregulation; flow cytometry

Received: February 11, 2013; Accepted: May 15, 2013; Published: August 1, 2013  Show citation