Sepsis: Epidemiology, Pathophysiology, and Management.
6 affiliations
- 1Yancheng Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine (Yancheng Hospital of Traditional Chinese Medicine) Yancheng Jiangsu China.
- 2Faculty of Chinese Medicine Macau University of Science and Technology Macau SAR China.
- 3School of Pharmacy Macau University of Science and Technology Macau SAR China.
- 4Laboratory of Drug Discovery from Natural Resources and Industrialization Macau University of Science and Technology Macau SAR China.
- 5Faculty of Chinese Medicine State Key Laboratory of Mechanism and Quality of Chinese Medicine Macau University of Science and Technology Macau SAR China.
- 6Zhuhai MUST Science and Technology Research Institute Zhuhai Guangdong China.
Abstract
Sepsis remains a major cause of global morbidity and mortality despite advances in recognition, antimicrobial therapy, and organ support, reflecting its biological heterogeneity and the absence of broadly effective host-directed treatments. Here, we synthesize recent evidence across the three domains that define contemporary sepsis: epidemiology, pathophysiology, and management. Global and regional data indicate a persistently high but uneven burden, shaped by differences in case definitions, population structure, healthcare resources, and ascertainment. Mechanistically, sepsis is best viewed as an interconnected systems disorder in which hyperinflammation and immunoparalysis coexist with oxidative stress, endothelial and coagulation injury, immunometabolic dysfunction, gut dysbiosis, mitochondrial damage, and dysregulated programmed cell death, collectively driving organ dysfunction. Current management remains centered on timely antimicrobials, source control, individualized fluid and vasopressor therapy, corticosteroids, and organ support, while biomarker-guided immunotherapy and other host-directed strategies remain investigational. Recent randomized trials have mainly refined how established treatments are delivered rather than identified a universally effective new therapy. We also evaluate preclinical evidence for natural compounds targeting inflammatory and cell-death networks and highlight persistent methodological, pharmacokinetic, and translational barriers. Integrating rigorous phenotyping, mechanistic biomarkers, and guideline-based care may provide a more realistic path toward precision sepsis therapy.
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BibTeX
@article{pan2026sepsis,
title = {{Sepsis: Epidemiology, Pathophysiology, and Management.}},
author = {Guang-Tao Pan and Yu Deng and Lin-Rui Ma and Yu-Tong Li and Yu Qian and Yi-Hua Ma and Hai-Wei Rao and Yi-Zhun Zhu and Pei-Yu Yan},
journal = {MedComm},
year = {2026},
month = oct,
doi = {10.1002/mco2.71079},
url = {https://europepmc.org/article/MED/42948031},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sepsis: Epidemiology, Pathophysiology, and Management.
AU - Guang-Tao Pan
AU - Yu Deng
AU - Lin-Rui Ma
AU - Yu-Tong Li
AU - Yu Qian
AU - Yi-Hua Ma
AU - Hai-Wei Rao
AU - Yi-Zhun Zhu
AU - Pei-Yu Yan
PY - 2026
DA - 2026/10/27
JO - MedComm
DO - 10.1002/mco2.71079
UR - https://europepmc.org/article/MED/42948031
AB - Sepsis remains a major cause of global morbidity and mortality despite advances in recognition, antimicrobial therapy, and organ support, reflecting its biological heterogeneity and the absence of broadly effective host-directed treatments. Here, we synthesize recent evidence across the three domains that define contemporary sepsis: epidemiology, pathophysiology, and management. Global and regional data indicate a persistently high but uneven burden, shaped by differences in case definitions, population structure, healthcare resources, and ascertainment. Mechanistically, sepsis is best viewed as an interconnected systems disorder in which hyperinflammation and immunoparalysis coexist with oxidative stress, endothelial and coagulation injury, immunometabolic dysfunction, gut dysbiosis, mitochondrial damage, and dysregulated programmed cell death, collectively driving organ dysfunction. Current management remains centered on timely antimicrobials, source control, individualized fluid and vasopressor therapy, corticosteroids, and organ support, while biomarker-guided immunotherapy and other host-directed strategies remain investigational. Recent randomized trials have mainly refined how established treatments are delivered rather than identified a universally effective new therapy. We also evaluate preclinical evidence for natural compounds targeting inflammatory and cell-death networks and highlight persistent methodological, pharmacokinetic, and translational barriers. Integrating rigorous phenotyping, mechanistic biomarkers, and guideline-based care may provide a more realistic path toward precision sepsis therapy.
SN - 2688-2663
ER -