Figure 6.

Stages of sepsis. Early in sepsis, both inflammation and immunosuppression occur concurrently. If inflammation is uncontrolled, this leads to organ failure and death. Those that avoid early death will either return to immune homeostasis, or progress to prolonged immunosuppression that continues after discharge. Prolonged immunosuppression predisposes survivors to infections, rehospitalizations, and ultimately to death. This phenomenon is marked by impaired cytokine secretion, dysfunctional T cells, and cellular reprogramming. Expansion of regulatory T cell and myeloid-derived suppressor cell (MDSC) populations also occurs early in sepsis and persists after sepsis, suggesting their role in maintaining this immunosuppressive phenotype.