Joint profiling of immune-endothelial cells in sepsis: promise, pitfalls, and the path forward

Sepsis can result in organ dysfunction and death through the convergence of immune dysregulation and microvascular endothelial injury.1,2 Although the host immune response is routinely profiled among critically ill patients,3 the endothelium has escaped the same scrutiny because vascular beds are not readily accessible for sampling. Circulating endothelial cells (cECs), rare cells shed into peripheral blood, offer a window into this compartment, but their identification is complicated by overlap with activated monocytes through shared expression of HLA-DR, CD16, and several adhesion molecules.