title: Monitoring immune dysfunctions in the septic patient: a new skin for the old ceremony.
abstract: Septic syndromes represent a major although largely underrecognized healthcare problem worldwide, accounting for thousands of deaths every year. It is now agreed that sepsis deeply perturbs immune homeostasis by inducing an initial tremendous systemic inflammatory response which is accompanied by an antiinflammatory process, acting as negative feedback. This compensatory inhibitory response secondly becomes deleterious as nearly all immune functions are compromised. These alterations might be directly responsible for worsening outcome, as they may play a major role in the decreased resistance to nosocomial infections in patients who survived initial resuscitation. Consequently, immunostimulatory therapies may now be assessed for the treatment of sepsis. This review focuses on immune dysfunctions described in septic patients and on their potential use as markers on a routine standardized basis for prediction of adverse outcome or of occurrence of secondary nosocomial infections. This constitutes a prerequisite to a staging system for individualized treatment for these hitherto deadly syndromes.
authors.affiliation: Hospices civils de Lyon, Immunology laboratory, Hopital E. Herriot, Lyon, France. guillaume.monneret@chu-lyon.fr
authors.forename: Guillaume
authors.initials: G
authors.lastname: Monneret
authors.forename: Fabienne
authors.initials: F
authors.lastname: Venet
authors.forename: Alexandre
authors.initials: A
authors.lastname: Pachot
authors.forename: Alain
authors.initials: A
authors.lastname: Lepape
mesh_terms: D003428:Cross Infection / Q000276:immunology*; D006801:Humans; D007109:Immunity / Q000276:immunology*; D007113:Immunity, Innate / Q000276:immunology; D007167:Immunotherapy; D007249:Inflammation / Q000276:immunology; D018836:Inflammation Mediators / Q000097:blood; D011379:Prognosis; D018805:Sepsis / Q000276:immunology* / Q000628:therapy; D018746:Systemic Inflammatory Response Syndrome / Q000276:immunology
chemical_list: D018836:Inflammation Mediators