The persistent inflammation, immunosuppression, and catabolism syndrome 10 years later

Philip A. Efron; Scott C. Brakenridge; Alicia M. Mohr; Evan L. Barrios; Valerie E. Polcz; Stephen D. Anton; Tezcan Ozrazgat‐Baslanti; Azra Bihorac; Faheem W. Guirgis; Tyler J. Loftus; Martin Rosenthal; Christiaan Leeuwenburgh; Robert T. Mankowski; Lyle L. Moldawer; Frederick A. Moore

doi:10.1097/ta.0000000000004087

August 8, 2023Journal of Trauma and Acute Care SurgeryOpen Access

The persistent inflammation, immunosuppression, and catabolism syndrome 10 years later

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Key Points

To review a decade of translational research characterizing the pathophysiology, biomarkers, and clinical consequences of persistent inflammation, immunosuppression, and catabolism syndrome in chronically critically ill patients.
Synthesized multi-year clinical and translational findings from the University of Florida Sepsis and Critical Illness Research Center (UF SCIRC) cohort.
Evaluated physiological domains including immune function, metabolic pathways, hematopoiesis, organ injury, and age-related risk factors.
Identified persistent systemic inflammation, sustained adaptive immunosuppression, and unchecked hypercatabolism leading to severe sarcopenia as the core features of chronic critical illness.
Demonstrated that adverse outcomes are compounded by acute kidney injury, emergency myelopoiesis, dysregulated red blood cell production, and dysfunctional high-density lipoproteins.
Showed that advanced age substantially amplifies vulnerability to persistent immune and metabolic dysregulation, resulting in accelerated physical decline.

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Implication

Review highlights mechanisms driving persistent inflammation, immunosuppression, and catabolism syndrome in chronic critical illness, suggesting targets to improve recovery.

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Efron et al. (2023) studied this question.

synapsesocial.com/papers/6a1280c5ea48cb855a34fa7f https://doi.org/10.1097/ta.0000000000004087

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The persistent inflammation, immunosuppression, and catabolism syndrome 10 years later

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