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Macrophage reprogramming and functional plasticity in sepsis
Tengyue Huang1, Huiling Cheng2, Qianru Zhao1
1Department of Critical Care Medicine, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
Frontiers in Immunology
|March 18, 2026
Summary
Sepsis mortality stems from a dysregulated host immune response, not infection. Epigenetic changes in macrophages critically influence sepsis progression and offer potential therapeutic targets.
Area of Science:
- Immunology
- Molecular Biology
- Genetics
Background:
- Sepsis is a leading global cause of death, characterized by a dysregulated host response leading to cytokine storm and immune paralysis.
- Macrophages are key immune cells in sepsis, regulating inflammatory and reparative processes.
- Epigenetic regulation significantly impacts macrophage behavior during sepsis.
Purpose of the Study:
- To review the role of epigenetic regulation in macrophage function during sepsis.
- To elucidate how epigenetic mechanisms control sepsis initiation, progression, and resolution.
- To identify potential epigenetic therapeutic targets for sepsis.
Main Methods:
- Literature review of recent discoveries in sepsis and epigenetics.
- Analysis of epigenetic mechanisms including DNA methylation, histone modifications, and non-coding RNAs.
- Integration of findings to understand macrophage polarization and memory in sepsis.
Main Results:
- Epigenetic modifications dynamically regulate macrophage activation, polarization, and memory.
- These epigenetic programs are crucial for the initiation, progression, and resolution phases of sepsis.
- Understanding these mechanisms reveals potential therapeutic avenues.
Conclusions:
- Epigenetic regulation is a critical determinant of macrophage function in sepsis.
- Targeting epigenetic mechanisms in macrophages holds promise for novel sepsis therapies.
- Further research is needed to fully harness epigenetic strategies for sepsis treatment.

