Review Article

Langenbeck's Archives of Surgery

, Volume 399, Issue 1, pp 1-9

First online:

Immunopathogenesis of abdominal sepsis

  • Georg F. WeberAffiliated withDepartment of Surgery, University Hospital Carl Gustav Carus, Technical University Dresden Email author 
  • , Filip K. SwirskiAffiliated withCenter for Systems Biology, Massachusetts General Hospital and Harvard Medical School

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Sepsis is an unsolved problem worldwide, with a 30–50 % mortality rate. The recent failures of anti-TLR4, recombinant activated protein C, and anti-TNF in clinical trials indicate a need to rethink our current understanding of sepsis’s pathophysiology. While the initial immune response is crucial for effective clearance of invading pathogens, an overly exuberant host response to infection can cause septic shock, tissue damage, and death. Profuse inflammation in sepsis is frequently followed by global immunosuppression that increases susceptibility to viral and bacterial infections. Despite the dangers of immune over-response, the immune system’s anti-inflammatory activities are likely necessary to reduce the initial over-activation of the immune system.


With this review, we want to illuminate the different aspects of immune response to sepsis and provide insight to the ongoing difficulties currently present within sepsis research.


Future treatment strategies for sepsis should focus on maintaining balance between pro- and anti-inflammatory immune actions in a timely manner.


Sepsis Immune regulation Translational research