Molecular aspects and translational perspectives in sepsis: A narrative review.

Abstract

Sepsis is a leading cause of morbidity and mortality in critically ill patients, and its definition has evolved from the initial concept of systemic inflammatory response syndrome (SIRS) to the current one based on organ dysfunction as measured by the SOFA scale. Despite improvements in diagnosis and management, challenges persist due to variability in host response and antimicrobial resistance. This work was based on a non-systematic literature search in databases such as PubMed, ScienceDirect, Embase and MEDLINE, using key terms related to sepsis and focusing on relevant original studies and systematic reviews published between 1994 and 2024. Translational medicine has identified key biomarkers such as sTREM-1, Ang-2/Ang-1, and procalcitonin, which have demonstrated utility in early diagnosis, monitoring therapeutic response, and risk stratification in patients with sepsis. Promising therapies include PD-1/PD-L1 inhibitors, thymosin alpha 1 (Tα1), and extracellular vesicles of mesenchymal stem cells (EV-MSCs), which seek to modulate the dysregulated inflammatory response and preserve organ function. The future of sepsis management lies in the implementation of rapid diagnostic tools and personalized therapies that optimize clinical outcomes, highlighting the need for a comprehensive and multidisciplinary approach.