Current status of immunomodulatory therapies in adult sepsis patients: where do we stand?

Precision immunotherapy may represent the next step in sepsis management. Recent breakthrough studies have led to the identification of biomarkers that classify patients into distinct endotypes and predict response to treatment. These biomarkers need to guide us through the proper selection of patients, the timely initiation and cessation of treatment and sometimes even the adaptation to another endotype. The integration of serial immune monitoring, adaptive clinical trial designs, and endotype-specific treatment algorithms have the potential to move the field forward.