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Semin Respir Crit Care Med 2024; 45(04): 516-522
DOI: 10.1055/s-0044-1787992
Review Article

Informative Subtyping of Patients with Sepsis

John Cafferkey 
1   Department of Anaesthesia, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
,
Manu Shankar-Hari 
2   Centre for Inflammation Research, Institute For Regeneration and Repair, University of Edinburgh, Edinburgh, Scotland, United Kingdom
› Author Affiliations Funding M.S.H. was supported by the National Institute of Health Research Clinician Scientist Award (award no.: CS-2016-16-011; 2017–2023). M.S.H. acknowledges a program grant named Time critical precision medicine for acute critical illness using treatable trait principles: TRAITS Program (PMAS/21/08) from Chief Scientist's Office, Scotland (see link https://traits-trial.ed.ac.uk ).
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Abstract

Sepsis pathobiology is complex. Heterogeneity refers to the clinical and biological variation within sepsis cohorts. Sepsis subtypes refer to subpopulations within sepsis cohorts derived based on these observable variations and latent features. The overarching goal of such endeavors is to enable precision immunomodulation. However, we are yet to identify immune endotypes of sepsis to achieve this goal. The sepsis subtyping field is just starting to take shape. The current subtypes in the literature do not have a core set of shared features between studies. Thus, in this narrative review, we reason that there is a need to a priori state the purpose of sepsis subtyping and minimum set of features that would be required to achieve the goal of precision immunomodulation for future sepsis.

Keywords

sepsis - phenotypes - endotypes - infectious disease - critical care - subtypes - precision medicine

Authors' Contributions

Structure of this invited narrative review was conceived by J.C. and M.S.H. Contributor J.C. had access to all the published cohort-level data summarized in this narrative review and take responsibility for the integrity of the data tabulation. The first draft of manuscript was by J.C. and underwent critical revision by J.C. and M.S.H. Administrative, technical, and material support was provided by M.S.H. Authors J.C. and M.S.H. have read the final draft of the manuscript and confirm the integrity of the work.


Note

The views expressed in this article are those of the authors and not necessarily those of the National Health Service, NIHR or Department of Health and Social Care. The funders of the study had no role in review or approval of the manuscript, or the decision to submit for publication.




Publication History

Article published online:
08 July 2024

© 2024. Thieme. All rights reserved.

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