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MINI REVIEW article

Front. Immunol.

Sec. Inflammation

Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1643194

This article is part of the Research TopicInflammation, Immunity, and Cancer: New Pathways Towards Therapeutic InnovationView all 10 articles

The immunosuppressive mechanisms induced by sepsis and the corresponding treatment strategies

Provisionally accepted
Qinfen  GaoQinfen Gao1Teng  YajunTeng Yajun1Lin  ZhuLin Zhu1Zengzheng  LiZengzheng Li1*Wei  ZhangWei Zhang2*
  • 1The First People’s Hospital of Yunnan Province, Kunming, China
  • 2First Affiliated Hospital of Kunming Medical University, Kunming, China

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

[Abstract]: Sepsis is a life-threatening organ dysfunction caused by the dysregulation of the body's response to infection. It is characterized by a high incidence, high mortality rate, and high medical burden, and is a major global health threat. Although updated treatment guidelines have reduced the mortality rate during the acute phase, survivors still face a high long-term risk of recurrent infection and death. Recent studies have shown that the long-term high mortality rate of sepsis is closely related to the immunosuppression it induces. Sepsis-induced immunosuppression originates from the disruption of immune homeostasis, characterized by excessive release of anti-inflammatory cytokines, increased apoptosis of immune cells (especially lymphocytes), T cell exhaustion, and expansion of immune regulatory cells (Tregs, MDSCs). Reduced expression of human leukocyte antigen-DR (HLA-DR) and upregulated expression of immune checkpoint molecules (PD-1, CTLA-4, TIM-3, etc.) further exacerbate immunosuppression. This article systematically reviews the immune imbalance state and related mechanisms of patients with sepsis, and summarizes new immunotherapy strategies such as immune stimulatory factors (GM-CSF, IL-7, IL-15), immune checkpoint inhibitors (anti-PD-1/PD-L1, anti-CTLA-4, anti-TIM-3), and emerging therapies (mesenchymal stem cells, calprotectin inhibitors, TREM-1 inhibitors). The aim is to enhance clinicians' understanding of sepsis-induced immunosuppression, facilitate early intervention, and reduce the incidence and mortality of long-term complications.

Keywords: Sepsis, Immunosuppression, Immune metabolism, Immune homeostasis, Cytokines, Therapeutic target

Received: 08 Jun 2025; Accepted: 06 Oct 2025.

Copyright: © 2025 Gao, Yajun, Zhu, Li and Zhang. 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:
Zengzheng Li, lizengzheng@126.com
Wei Zhang, 14258986@qq.com

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