Peer-Reviewed Publication
Nat Med2025;31(12):4084-4096.December 1, 2025Journal Article
A consensus immune dysregulation framework for sepsis and critical illnesses.
Andrew R Moore1,2,3, Hong Zheng2,3, Ananthakrishnan Ganesan2,3, Yehudit Hasin-Brumshtein4, Manoj V Maddali1,3, Joseph E Levitt1, Tom van der Poll5,6, Jingyi Lu7,8, Hjalmar R Bouma7,8,9, Brendon P Scicluna10, Evangelos J Giamarellos-Bourboulis11,12, Antigone Kotsaki11,12, Ignacio Martin-Loeches13,14, Alexis Garduno13, Jeremiah Hinson15, Richard E Rothman15, Jonathan Sevransky16, David W Wright17, Mihir R Atreya18, Lyle L Moldawer19, Philip A Efron19, Marcela Kralovcova20, Thomas Karvunidis20, Heather M Giannini21, Nuala J Meyer21, Timothy E Sweeney4, Angela J Rogers1, Purvesh Khatri22,23
1Division of Pulmonary, Allergy and Critical Care Medicine, Stanford University, Stanford, CA, USA.
2Institute for Immunity, Transplantation and Infection, Stanford University, Stanford, CA, USA.
3Center for Biomedical Informatics Research, Department of Medicine, Stanford University, Stanford, CA, USA.
4Inflammatix Inc., Sunnyvale, CA, USA.
5Center of Experimental and Molecular Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
6Division of Infectious Diseases, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
7Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
8Department of Acute Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
9Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
10Department of Applied Biomedical Science, Faculty of Health Sciences, and Centre for Molecular Medicine and Biobanking, University of Malta, Msida, Malta.
114th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
12Hellenic Institute for the Study of Sepsis, Athens, Greece.
13Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James's Hospital, Dublin, Ireland.
14Hospital Clinic, Universitat de Barcelona, IDIBAPS, CIBERES, Barcelona, Spain.
15Department of Emergency Medicine, The Johns Hopkins University, Baltimore, MD, USA.
16Division of Pulmonary, Allergy, Critical Care and Sleep and Emory Critical Care Center, Emory University, Atlanta, GA, USA.
17Department of Emergency Medicine, Emory University, Atlanta, GA, USA.
18Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
19Sepsis and Critical Illness Research Center and the SPIES Consortium, University of Florida College of Medicine, Gainesville, FL, USA.
201st Department of Internal Medicine, Faculty of Medicine, Teaching Hospital and Biomedical Center in Pilsen, Charles University, Pilsen, Czech Republic.
21Division of Pulmonary, Allergy, and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
22Institute for Immunity, Transplantation and Infection, Stanford University, Stanford, CA, USA. pkhatri@stanford.edu.
23Center for Biomedical Informatics Research, Department of Medicine, Stanford University, Stanford, CA, USA. pkhatri@stanford.edu.
Abstract
Critical care syndromes such as sepsis, acute respiratory distress syndrome (ARDS) and trauma continue to have unacceptably high morbidity and mortality, with progress limited by the inherent heterogeneity within syndromic illnesses. Although numerous immune endotypes have been proposed for sepsis and critical care, the similarities and differences between these endotypes remain unclear, hindering…
Create a free account to keep reading
Free members get 10 full research views every month across publications, clinical trials, FDA clearances, adverse events, and NIH grants. No credit card required.
Want unlimited research access? See Pro plans