REVIEW article

Front. Immunol.

Sec. Systems Immunology

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1627313

This article is part of the Research TopicExploring Immunomodulation to Balance Maladaptive Inflammation and Restore Tissue HomeostasisView all 4 articles

Considering Local Immunity for Innovative Immunomodulatory Approaches: Pulmonary Sepsis as a use case

Provisionally accepted
Emilie VernayEmilie Vernay1,2Elisabeth CerratoElisabeth Cerrato1,2François SantinonFrançois Santinon1,2Céline MonardCéline Monard3Pauline PerezPauline Perez3Florence AllantazFlorence Allantaz1,2Anne-Claire LukaszewiczAnne-Claire Lukaszewicz1,3Jean-François LlitjosJean-François Llitjos1,2,3*
  • 1EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Joint Research Unit Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux, Lyon, France
  • 2Innovation and Partnership, (I&P), bioMérieux S.A., Marcy L'Etoile, France
  • 3Anaesthesia and Critical Care Medicine Department, Hospices Civils de Lyon, Edouard Herriot Hospital, Lyon, France

The final, formatted version of the article will be published soon.

Select one of your emails

You have multiple emails registered with Frontiers:

Notify me on publication

Please enter your email address:

If you already have an account, please login

You don't have a Frontiers account ? You can register here

Owing to faster identification of sepsis and improvement of patient management, most septic patients now survive the early phase of sepsis. Therefore, one of the major challenges in sepsis management today is to identify those patients at risk and propose effective personalized therapy. The complexity of the mechanisms involved in the septic immune response and its dysregulation is reflected in the diversity of immune profiles among sepsis patients. It is now well recognized that this heterogeneity is a major obstacle to stratifying patients based on their susceptibility to secondary infections. Since sepsis can originate from different anatomical sites, some studies have investigated their impact to decipher the heterogeneity. They concluded that the site of infection affects patient outcomes and leads to different immune alterations. This narrative review focuses on pulmonary sepsis to highlight the importance of studying organ response directly with local immune cells. Understanding the persistent dysregulation within the lung, whether it involves pulmonary immune cells or other lung components, is critical. Some studies have already examined the remodeling and loss of functionality of alveolar macrophages after the initial insult. Ongoing research is also investigating the impact of imbalances in other lung players, such as epithelial cells or the microbiota, on susceptibility to pulmonary reinfection.

Keywords: Sepsis, Compartmentalisation, Alveolar macrophages (AM), lung infection, Pulmonary microbiota

Received: 12 May 2025; Accepted: 08 Jul 2025.

Copyright: © 2025 Vernay, Cerrato, Santinon, Monard, Perez, Allantaz, Lukaszewicz and Llitjos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jean-François Llitjos, EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Joint Research Unit Université Claude Bernard Lyon 1 - Hospices Civils de Lyon - bioMérieux, Lyon, France

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material