Figure 1.

Revised model of inflammation in sepsis. The traditional biphasic model of sepsis (19) plots the immune system on a timeline with an initial hyperinflammatory cytokine storm followed by hypoinflammatory immune paralysis. However, clinical evidence does not support well-demarcated immune phases. In this revised model, the initial immune response to sepsis is a continuous mix of pro- and anti-inflammatory processes that lead to specific immune reprogramming. These programs include persistently pro- or anti-inflammatory and primed responses. The duration and magnitude of each inflammatory program is likely result of many determining factors.