Hyper-inflammation and immunosuppression: redefining sepsis therapy using modern approaches

Sepsis is a life-threatening condition characterized by simultaneous hyperinflammation and immunosuppression, which leads to organ dysfunction and mortality. It is a global health concern, which is estimated to be approximately 166 million cases and 21.4 million global deaths in 2021.

This review aimed to analyze sepsis epidemiology, pathophysiology, current therapeutic approaches and challenges, and assess the transformational role of modern therapeutic approaches, including precision medicine, and Artificial Intelligence (AI)/Machine Learning (ML) in sepsis.

A literature search was carried out across multiple databases, including PubMed, Web of Science, and Scopus. The search was focused on hyperinflammation, immunosuppression in sepsis, current therapy, and future advances.

The review integrated the search data from original articles, review papers, and clinical trials. After careful analysis, we observed that the efficacy of current therapy is limited due to the heterogeneity of sepsis patients, the lack of patient selection based on immune status, timing, and validated biomarkers. Precision methods based on classifying patient genotypes and multi-omics-based biomarkers suggest a potential approach to risk stratification and therapeutic guidance. Concurrently, AI/ML models exhibit improved predictive accuracy and early clinical diagnosis, facilitating early identification and risk stratification.

The integration of AI/ML and precision medicine into sepsis care has the potential to reduce mortality in clinically significant endotypes and allow focused immunomodulatory treatments fulfilling Sustainable Development Goal 3.