Precision medicine in sepsis and septic shock: From omics to clinical tools

Table 1 Clinical applicability of precision medicine strategies

Precision medicine strategy	Target (s)	Clinical application
Genomics and epigenomics	Genetic variants	Prognosis, severity
	Genotypes	Susceptibility to sepsis
Transcriptomics	Gene expression profiles, activity and regulation	Susceptibility to sepsis
	Sepsis response signatures	Severity, prognosis
Metabolomics	Small molecules produced by cells	Prognosis
	Metabolomic profile	Response to treatment
Proteomics	Proteins expressed by the genome under certain conditions	Diagnosis, Prognosis
	Biomarkers	Diagnosis, prognosis
Bioinformatics	Machine learning techniques	Diagnosis
		Prediction of clinical trajectories
		Assessment and treatment of organ dysfunction
		Clinical phenotypes
Biomarkers	Levels of molecules (mostly inflammatory)	Phenotypes
		Antimicrobial stewardship
		Prediction of organ dysfuntion
		Allocation of hospital resources
		Diagnosis
		Severity
Immunoglobulins	Immunoglobulin levels	Detection and treatment of sepsis-associated hypogammaglobulinemia
Endotoxin and hemoadsoption	Endotoxin levels and elimination by hemoadsoption	Rescue therapy
Cytokines and hemoadsoption	Cytokine levels and elimination by hemoadsoption	Rescue therapy
Immunoparalysis	mHLA-DR expression	Immunoparalysis detection
		Immunoadjuvant treatment
		Stratification of patients
		GM-CSF therapy

GM-CSF: Granulocyte-macrophage colony-stimulating factor.