Biosensing Platforms and Multimodal Monitoring of Sepsis-Associated Cell Death

Apoptosis plays an important role in sepsis-associated immune dysfunction, particularly through lymphocyte depletion and the development of persistent immunosuppression. This review examines apoptosis-associated biomarkers in sepsis, distinguishing relatively direct markers of cell death from complementary indicators of immune dysfunction, inflammation, and organ injury, and considers their potential for longitudinal monitoring. Particular attention is given to biosensing platforms that may enable rapid, low-volume, and multiplexed detection of these biomarkers. Representative electrochemical, optical, nanoparticle-assisted, and microfluidic approaches are discussed in terms of their analytical performance, biological relevance, and stage of clinical translation. The review also considers how serial biosensor measurements could be combined with physiological signals, conventional laboratory parameters, and organ dysfunction scores to follow changes in the patient's biological and clinical status over time. Artificial intelligence and machine-learning methods may facilitate the interpretation of these complex datasets and support multimodal patient assessment. However, most biosensors targeting relatively direct apoptosis-associated markers remain at the experimental stage, and their added clinical value in sepsis has not yet been established. Future studies should therefore determine whether serial assessment of cell-death-associated biomarkers provides meaningful information beyond currently available inflammatory biomarkers, physiological monitoring, and severity scores.