Immune Dysregulation in Sepsis

The systemic inflammatory response syndrome is a manifestation of the host's immune response to infection. With an aim to eradicate the pathogen, the immune system is activated to encourage a state of inflammation, which is followed by a number of interactions to restore homeostasis. This balance is mediated by a complex interplay among many immune components, which at times can lead to an excessive anti-inflammatory environment, the compensatory anti-inflammatory response syndrome. Numerous cellular and chemokine mediators such as monocytes and granulocyte-macrophage colony-stimulating factor are involved in the manifestation of this syndrome and, if further dysregulated, can lead to immunoparalysis, a prolonged anti-inflammatory environment placing the host at risk for potentially life-threatening infections. Understanding these complex immune reactions may help better identify immune dysregulation during sepsis, holding important implications for the clinician when managing septic patients.