Abstract
Sepsis and septic shock represent the important medical and socio-economic burden worldwide. The double-phased concept of significant immune homeostasis impairment in sepsis has generally been accepted.
In this theory, the initial phase is characterized by enormous activation of immune system followed by the compensatory phase resulting profound immunosuppression. However, this paradigm has recently been challenged and the concept of simultaneous pro-inflammatory, anti-inflammatory and adaptive immunity suppressing response occurring even early in sepsis has been introduced.
These immune alterations leading to the failure to combat relatively avirulent nosocomial and opportune pathogens and prolonged multiorgan dysfunction seem to be the major cause of increased morbidity and mortality in critically ill patients. This review briefly summarizes the current concept of sepsis-induced immune deregulation and discusses diagnostic tools and emerging immune-based therapeutic interventions.