Immune reaction to sepsis: too strong, too weak or both?

[22.09.2022] Until now, it was assumed that sepsis and multiorgan failure are predominantly consequences of an overshooting immune response ("cytokine storm"). A new study shows that it is not that simple. An interdisciplinary team from the Department of Anaesthesiology and Intensive Care Medicine (Prof. Dr. J. Peters) and the Institute of Medical Microbiology (Prof. Dr. C. Kirschning) of the Faculty of Medicine of the University of Duisburg-Essen has discovered that blood samples from intensive care patients show significantly reduced immune responses already on the first day after sepsis onset (according to current sepsis-3 criteria). They recently published their findings in "PLOS One."
"While patients’ blood samples showed high inflammatory activity, in comparison to whole blood from healthy individuals they weakly responded to toll-like receptor ligands, bacteria, and bacterial lipopolysaccharide, although these factors usually evoke a strong immune response," says Willem Buys, doctoral student at the University Hospital Essen and co-first author. "In addition, there was no response ex vivo to immune checkpoint inhibitors, a group of drugs used for cancer therapy and currently being considered for sepsis therapy to boost the immune response," says first author Dr. Alexandra Bick from the Department of Anaesthesiology and Intensive Care Medicine.
The question of whether immune activation might nevertheless be suitable as a potential sepsis therapy is something the scientists would like to explore in follow-up studies. "Beginning in November I plan to take-up research projects as a postdoctoral fellow at the Johns Hopkins University in Baltimore" says Buys, who is only 26 years old.


Link to original publication: Immune hyporeactivity to bacteria and multiple TLR-ligands, yet no response to checkpoint inhibition in patients just after meeting sepsis-3 criteria