{
  "abstract": "Persistent inflammation, immunosuppression, and catabolism syndrome (PICS) is a phenotype of chronic critical illness characterized by unresolved inflammation, impaired immune competence, sustained catabolism, skeletal muscle loss, recurrent infections, and poor functional recovery. Although guideline-based nutritional support remains fundamental, persistent immunometabolic abnormalities may limit responsiveness to nutrient delivery and contribute to anabolic resistance, impaired substrate utilization, and defective tissue repair. This mini-review examines biological mechanisms limiting nutritional responsiveness in PICS and evaluates evidence for pathophysiology-guided nutritional strategies. A structured literature search of PubMed/MEDLINE, Embase, and Web of Science was conducted from database inception through September 6, 2026, prioritizing English-language clinical guidelines, clinical studies, and mechanistic or translational evidence relevant to PICS, critical illness, nutritional responsiveness, and immunometabolic nutrition. We propose a framework addressing major barriers to recovery through strategies to restore anabolic responsiveness with protein, leucine, and rehabilitation; modulate inflammatory resolution and immune dysfunction with omega-3 fatty acids and arginine; optimize nutrient timing and circadian-metabolic regulation; and maintain a metabolic milieu conducive to nutrient utilization. Because direct interventional evidence in well-defined PICS populations remains limited, these strategies should complement rather than replace guideline-based nutritional support. The framework is conceptual and hypothesis-generating, and prospective PICS-specific studies incorporating biological stratification and clinically meaningful recovery outcomes are needed to determine its translational value.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Critical Care Medicine, Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhiyang Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Bo Yao"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4tfz3z1qn16mk.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1968812",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13729763/?tool=EBI",
  "id": "4tfz3z1qn16mk",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1968812/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Mini Review"
    ],
    [
      "openalex",
      "2916|Clinical Nutrition and Gastroenterology"
    ]
  ],
  "openalex": "W7223066924",
  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1968812/pdf",
  "pmcid": "PMC13729763",
  "pmid": "42979465",
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/4tfz3z1qn16mk.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:17Z",
      "native_id": "10.3389/fimmu.2026.1968812",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1968812/full"
    },
    {
      "first_seen": "2026-11-04T15:20:46Z",
      "native_id": "PMC:PMC13729763",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13729763"
    },
    {
      "first_seen": "2026-11-07T12:22:30Z",
      "native_id": "PMC13729763",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fimmu.2026.1968812"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "issn:1664-3224",
      "subfield": "immunology"
    }
  ],
  "title": "Pathophysiology-guided nutritional strategies for persistent inflammation, immunosuppression, and catabolism syndrome: an immunometabolic perspective",
  "title_text": "Pathophysiology-guided nutritional strategies for persistent inflammation, immunosuppression, and catabolism syndrome: an immunometabolic perspective",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:22:30Z",
  "url": "https://research.draconitic.com/paper/4tfz3z1qn16mk",
  "venue": "Frontiers in Immunology",
  "versions": []
}