Figure 8.

The immunoinflammatory trajectory in a subject dying from the acute-type septic response. The scheme delineates immunoinflammatory fluctuations using the time of death as the reference point given that the time of the sepsis onset in patients is typically unknown. As the severity of sepsis progresses, the magnitude of the systemic pro- and anti-inflammatory cytokine response and cellular anergy increases. A prelethal immunoinflammatory status of a subject dying from acute sepsis is characterized by both a MARS-like cytokine profile (concurrent presence of both pro- and anti-inflammatory mediators in the blood) and distinct signs of anergy in the cellular compartment. An acute inflammatory response (hyperinflammation), although typically associated with early septic deaths, may occur at any chronological phase of the disease if a septic organism is sufficiently immunologically responsive. The scheme is largely based on data generated in the mouse model of CLP sepsis.