Sympathetic regulation of the host immune response to bacterial sepsis

Sepsis is a life-threatening condition that occurs when infection drives an overwhelming immune response that damages tissues and results in multi-organ dysfunction. Current treatment of sepsis focuses on eliminating the infectious pathogen and supporting the cardiovascular system. However, effective therapeutics for mitigating the dysregulated immune response in sepsis are still lacking. To this end, many sepsis survivors end up with immunoparalysis and an increased risk of recurring infections. Despite the growing body of research revealing the close interplay between the nervous and immune systems, modulating the neuroimmune pathways remains an unexplored route of treatment. The sympathetic arm of the autonomic nervous system, particularly β-adrenergic receptor signalling, is integral in limiting the inflammatory response during bacterial infections. However, our current understanding of the neuroimmune interactions and their impact on sepsis pathophysiology remains limited. In this review, we outline current insights into the neuroimmune response in sepsis, with a particular focus on the role of the sympathetic nervous system in modulating immune responses against bacterial infections. Elucidating the neural signalling pathways that regulate the immune response and recovery in sepsis will reveal new therapeutic targets to reduce disease burden and improve patient outcomes.