New Global Framework Pioneers Precision Medicine in Sepsis and Critical Care

In a groundbreaking advancement in critical care medicine, two parallel studies published in the esteemed journal Nature Medicine have laid the foundation for a unified approach to understanding and treating sepsis and other severe illnesses. Led by Dr. Brendon Scicluna from the University of Malta's Department of Applied Biomedical Science, these studies represent a significant step towards implementing precision medicine in intensive care settings.

One of the studies, titled "A Consensus Blood Transcriptomic Framework for Sepsis," compiled data from over 1,800 sepsis patients. By utilizing blood transcriptomics—a technique that analyzes gene activity to capture real-time immune responses—the researchers identified three distinct molecular subtypes of sepsis, known as Consensus Transcriptomic Subtypes (CTSs). These are:

• CTS1: Characterized by a vigorous, immature neutrophil-driven inflammatory response.
• CTS2: Marked by disruptions in blood clotting processes and heme management.
• CTS3: Features an immune state involving antiviral interferon signals, resembling organ transplant rejection scenarios.

This standardized classification aims to unify sepsis research, facilitating targeted therapies. Notably, reanalysis of clinical trial data highlighted that patients categorized as CTS2 experienced harm from corticosteroid treatments, emphasizing the importance of personalized approaches rather than a one-size-fits-all method.

The second study, "A Consensus Immune Dysregulation Framework for Sepsis and Critical Illnesses," involved an analysis of over 7,000 patient samples from 37 cohorts. It revealed two main patterns of immune dysregulation affecting myeloid and lymphoid cells, which are central to the immune defense. Remarkably, similar immune alterations were observed across other critical conditions such as ARDS, trauma, and burns, suggesting shared biological pathways.

Dr. Scicluna emphasizes the significance: "These studies are a landmark because they provide a common language for research and therapy development. Combining molecular profiles with clinical insights can transform how we treat critical illnesses."

Collectively, these findings present a new framework for designing clinical trials and developing treatments tailored to specific biological subtypes. They mark a crucial step towards actualizing the promise of precision medicine in the ICU, ultimately improving outcomes for some of the most vulnerable patients.

source: https://medicalxpress.com/news/2025-10-global-standard-precision-medicine-sepsis.html