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中华重症医学电子杂志 ›› 2026, Vol. 12 ›› Issue (02) : 112 -117. doi: 10.3877/cma.j.issn.2096-1537.2026.02.003

年度进展

脓毒症精准免疫治疗:2025
陈婉仪, 裴飞, 吴健锋()   
  1. 510080 广州,广东省急危重症医学临床研究中心 中山大学附属第一医院重症医学科
  • 收稿日期:2026-03-09 出版日期:2026-05-28
  • 通信作者: 吴健锋
  • 基金资助:
    国家科技重大专项(2025ZD01902600); 国家自然科学基金项目(82302415,82472221); 广东省基础与应用基础研究基金联合基金重点项目(2023B1515230005); 广东省急危重症医学临床研究中心(2020B1111170005); 中山大学5010研究项目(2024006)

Precision immunotherapy for sepsis in 2025

Wanyi Chen, Fei Pei, Jianfeng Wu()   

  1. Guangdong Clinical Research Center for Critical Care Medicine, Department of Critical Care Medicine, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
  • Received:2026-03-09 Published:2026-05-28
  • Corresponding author: Jianfeng Wu
引用本文:

陈婉仪, 裴飞, 吴健锋. 脓毒症精准免疫治疗:2025[J/OL]. 中华重症医学电子杂志, 2026, 12(02): 112-117.

Wanyi Chen, Fei Pei, Jianfeng Wu. Precision immunotherapy for sepsis in 2025[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2026, 12(02): 112-117.

近年来,脓毒症免疫治疗面临的核心挑战在于宿主免疫反应的高度异质性。围绕这一问题,2025年发表的多项研究在免疫表型识别、精准免疫治疗方面取得了重要进展。本文聚焦国内外发表的相关研究,总结当前脓毒症精准免疫治疗的进展,探讨其面临的挑战与机遇,为未来脓毒症精准免疫治疗提供新思路。

In recent years, a major challenge in sepsis immunotherapy has been the marked heterogeneity of host immune responses. Addressing this issue, numerous studies published in 2025 have advanced the understanding of immune phenotyping and the development of precision immunotherapeutic strategies. This review systematically summarizes both domestic and international research on precision immunotherapy in sepsis, highlighting current approaches, key findings, and emerging trends. In addition, it critically examines the challenges, limitations, and potential opportunities in the field, providing insights to guide future research and clinical application of individualized immunotherapy for sepsis.

表1 精准免疫治疗的最新研究
表2 精准分层的最新研究
1
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2
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3
Giamarellos-Bourboulis EJ, Kotsaki A, Kotsamidi I, et al. Precision immunotherapy to improve sepsis outcomes: the ImmunoSep randomized clinical trial [J]. JAMA, 2026, 335(9): 775-786.
4
Kox M, Bauer M, Bos LDJ, et al. The immunology of sepsis: translating new insights into clinical practice [J]. Nat Rev Nephrol, 2026, 22(1): 30-49.
5
Deinhardt-Emmer S, Chousterman BG, Schefold JC, et al. Sepsis in patients who are immunocompromised: diagnostic challenges and future therapies [J]. Lancet Respir Med, 2025, 13(7): 623-637.
6
Gu B, Zhou Y, Nie Y, et al. Efficacy of thymosin alpha1 for sepsis: a systematic review and meta-analysis of randomized controlled trials [J]. Front Cell Infect Microbiol, 2025, 15: 1673959.
7
Powers JH III, Natanson C. Immunotherapies for sepsis and the impact of study design [J]. BMJ, 2025, 388: r48.
8
Leventogiannis K, Kyriazopoulou E, Antonakos N, et al. Toward personalized immunotherapy in sepsis: The PROVIDE randomized clinical trial [J]. Cell Rep Med, 2022, 3(11): 100817.
9
脓毒症免疫调理治疗临床研究协作组. 乌司他丁、α1胸腺肽联合治疗严重脓毒症——一种新的免疫调理治疗方法的临床研究 [J]. 中华医学杂志, 2007, 87(7): 451-457.
10
Liu S, Yao C, Xie J, et al. Effect of an Herbal-Based Injection on 28-day mortality in patients with sepsis: the EXIT-SEP randomized clinical trial [J]. JAMA Intern Med, 2023, 183(7): 647-655.
11
Lou X, Chen H, Shi N, et al. Treatment effects of Xuebijing Injection in patients with sepsis by clinical phenotype: a post hoc analysis of the EXIT-SEP trial [J]. EClinicalMedicine, 2025, 86: 103341.
12
Seymour CW, Kennedy JN, Wang S, et al. Derivation, validation, and potential treatment implications of novel clinical phenotypes for sepsis [J]. JAMA, 2019, 321(20): 2003-2017.
13
Davenport EE, Burnham KL, Radhakrishnan J, et al. Genomic landscape of the individual host response and outcomes in sepsis: a prospective cohort study [J]. Lancet Respir Med, 2016, 4(4): 259-271.
14
Zheng H, Rao AM, Dermadi D, et al. Multi-cohort analysis of host immune response identifies conserved protective and detrimental modules associated with severity across viruses [J]. Immunity, 2021, 54(4): 753-768 e755.
15
Sweeney TE, Azad TD, Donato M, et al. Unsupervised analysis of transcriptomics in bacterial sepsis across multiple datasets reveals three robust clusters [J]. Crit Care Med, 2018, 46(6): 915-925.
16
Scicluna BP, Van Vught LA, Zwinderman AH, et al. Classification of patients with sepsis according to blood genomic endotype: a prospective cohort study [J]. Lancet Respir Med, 2017, 5(10): 816-826.
17
Cano-Gamez K, Burnham KL, Goh C, et al. An immune dysfunction score for stratification of patients with acute infection based on whole-blood gene expression [J]. Sci Transl Med, 2022, 14(669): eabq4433.
18
Yao L, Rey DA, Bulgarelli L, et al. Gene expression scoring of immune activity levels for precision use of Hydrocortisone in vasodilatory shock [J]. Shock, 2022, 57(3): 384-391.
19
Wong HR, Cvijanovich N, Lin R, et al. Identification of pediatric septic shock subclasses based on genome-wide expression profiling [J]. BMC Med, 2009, 7: 34.
20
Wong HR, Cvijanovich NZ, Anas N, et al. Developing a clinically feasible personalized medicine approach to pediatric septic shock [J]. Am J Respir Crit Care Med, 2015, 191(3): 309-315.
21
Cajander S, Kox M, Scicluna BP, et al. Profiling the dysregulated immune response in sepsis: overcoming challenges to achieve the goal of precision medicine [J]. Lancet Respir Med, 2024, 12(4): 305-322.
22
Scicluna BP, Cano-Gamez K, Burnham KL, et al. A consensus blood transcriptomic framework for sepsis [J]. Nat Med, 2025, 31(12): 4119-4130.
23
Pei F, Liu N, Yuan J, et al. Identification of distinct immune subtypes in sepsis through dual immunomarker trajectory [J]. Ann Intensive Care, 2026, 16: 100039.
24
Nagin DS, Jones BL, Passos VL, et al. Group-based multi-trajectory modeling [J]. Stat Methods Med Res, 2018, 27(7): 2015-2023.
25
Shankar-Hari M, Calandra T, Soares MP, et al. Reframing sepsis immunobiology for translation: towards informative subtyping and targeted immunomodulatory therapies [J]. Lancet Respir Med, 2024, 12(4): 323-336.
26
Butterfield LH, Najjar YG. Immunotherapy combination approaches: mechanisms, biomarkers and clinical observations [J]. Nat Rev Immunol, 2024, 24(6): 399-416.
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