Sepsis is characterised by a dysregulated host immune response to infection. Despite recognition of its significance, immune status monitoring is not implemented in clinical practice due in part to the current absence of direct therapeutic implications. Technological advances in immunological profiling could enhance our understanding of immune dysregulation and facilitate integration into clinical practice. In this Review, we provide an overview of the current state of immune profiling in sepsis, including its use, current challenges, and opportunities for progress. We highlight the important role of immunological biomarkers in facilitating predictive enrichment in current and future treatment scenarios. We propose that multiple immune and non-immune-related parameters, including clinical and microbiological data, be integrated into diagnostic and predictive combitypes, with the aid of machine learning and artificial intelligence techniques. These combitypes could form the basis of workable algorithms to guide clinical decisions that make precision medicine in sepsis a reality and improve patient outcomes.

中文翻译：

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分析脓毒症中失调的免疫反应：克服挑战以实现精准医疗的目标

脓毒症的特点是宿主对感染的免疫反应失调。尽管认识到其重要性，但免疫状态监测尚未在临床实践中实施，部分原因是目前缺乏直接的治疗意义。免疫分析技术的进步可以增强我们对免疫失调的理解，并有助于融入临床实践。在这篇综述中，我们概述了脓毒症免疫分析的现状，包括其使用、当前的挑战和进步的机会。我们强调免疫生物标志物在促进当前和未来治疗方案的预测丰富方面的重要作用。我们建议借助机器学习和人工智能技术，将多种免疫和非免疫相关参数（包括临床和微生物数据）整合到诊断和预测组合中。这些组合可以构成可行算法的基础，以指导临床决策，使脓毒症的精准医疗成为现实并改善患者的治疗结果。