Please use this identifier to cite or link to this item: http://localhost:8080/xmlui/handle/123456789/12273
Title: Subphenotypic Classification of Immune Response in Sepsis: Predicting Mortality and Guiding Future Personalized Immunotherapy
Authors: Herwanto, Velma
Lie, Khie Chen
Sinto, Robert
Nainggolan, Leonard
Keywords: sepsis
macrophage activation-like syndrome
immunoparalysis
subphenotype
Issue Date: Apr-2025
Publisher: Acta Medika Indonesia
Citation: Review Article
Abstract: The most recent definition of sepsis highlights the dysregulation of the host’s immune response to infection, which varies between individual hosts, with patients predominantly presenting with either hyperinflammation, immunoparalysis, or a combination of both states. Therefore, management strategies must be tailored to accommodate the heterogeneity of patients with sepsis, as these conditions are associated with distinct prognoses and therapeutic approaches. Identification of the immune response in patients with sepsis can be achieved through advanced techniques, such as gene expression profiling or, more simply, through a subphenotypic approach. This article introduces a subphenotypic classification of the sepsis immune response into macrophage activationlike syndrome (MALS), where pathological macrophage activation leads to excessive hyperinflammation, immunoparalysis, or neither. Patients are classified using serum ferritin levels and monocyte HLA-DR expression, which is assessed using peripheral blood. This classification demonstrates significant differences in survival across groups, which is attributed to their distinct underlying biological processes. Immunotherapeutic options also differ for these three groups. In the future, such immune response classifications will be valuable in sepsis management algorithms for personalized prognostication and therapy
URI: http://localhost:8080/xmlui/handle/123456789/12273
Appears in Collections:VOL 57 NO 2 2025

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