Immunomodulatory therapy for sepsis: from pathophysiological mechanisms to precision treatment

Sepsis is a life-threatening syndrome marked by immune dysregulation, progressing from hyperinflammation to immunosuppression. The translation of immunomodulatory therapies has been hampered by the disease’s extreme heterogeneity. This review synthesizes current progress and future perspectives in sepsis immunotherapy. We outline key immunopathological mechanisms and critically discuss evolving diagnostic tools, including dynamic biomarker monitoring and immune endotyping for personalized management. We then highlight novel therapeutic targets and explore how integrating single-cell technologies, dynamic profiling, and machine learning can guide stage-specific, precision treatment. Ultimately, a precision medicine framework combining multi-omics data with advanced bioengineering may offer new avenues to overcome the therapeutic impasse in sepsis.