Surgery-induced immune modulation: a comprehensive review
DOI:
https://doi.org/10.30978/GS-2026-2-56Keywords:
post-surgical immunomodulation, systemic inflammatory response syndrome, compensatory anti-inflammatory response syndrome, persistent inflammation, immunosuppression, and catabolism syndromeAbstract
Surgical intervention induces profound and dynamic alterations in the body’s immune reactivity. The postoperative period is typically characterized by an early hyperinflammatory response, followed by compensatory immunosuppression; however, in some cases, a maladaptive condition known as persistent inflammation, immunosuppression, and catabolism syndrome may develop. These immune disturbances are associated with an increased risk of infectious complications, impaired tissue repair, organ dysfunction, and potential tumor progression. Modulation of surgery-induced changes in immune responsiveness may represent a promising strategy for improving surgical outcomes. The aim of this review is to analyze and synthesize current literature on the mechanisms and key determinants of postoperative immunomodulation.
The review discusses the complex mechanisms underlying the initiation and progression of postoperative systemic hyperinflammation, as well as the triggers and pathways involved in compensatory anti-inflammatory response syndrome. Particular attention is given to the temporal dynamics and phase-dependent nature of postoperative immunomodulation. Key determinants shaping the intensity and trajectory of post-surgical immune responses are examined, including surgical factors such as the extent and duration of tissue injury, as well as anesthetic techniques and agents. In addition, patient-specific factors influencing postoperative immune modulation, such as age, sex, and preoperative immune status, are analyzed in detail.
Overall, the early postoperative period represents an underutilized window of therapeutic opportunity for improving surgical outcomes. However, its effective clinical exploitation requires a deeper understanding of the mechanisms underlying post-surgical immunomodulation, as well as the development and implementation of highly sensitive, dynamic biomarkers for continuous, real-time monitoring. Such advances would enable truly personalized, phase-adapted therapeutic strategies tailored to the patient’s evolving immune state.
References
Adib-Conquy M, Cavaillon JM. Compensatory anti-inflammatory response syndrome. Thromb Haemost. 2009 Jan;101(1):36-47. PMID: 19132187.
Ahmed R, Hamdy O, Alatawi A, Alhowidi A, Al-Dahshan N, Alkadah AN, Adnan S, Alali AM, Alwabisi YHO, Alruwaili S, Binmohaiya MB, Soliman AA, Elbakary M. The Role of Inflammatory Biomarkers in Predicting Postoperative Fever Following Flexible Ureteroscopy. Medicina (Kaunas). 2025 Jul 28;61(8):1366. http://doi.org/10.3390/medicina61081366. PMID: 40870412; PMCID: PMC12387940.
Akiyama M, Kanayama M, Umezawa Y, Nagao T, Izumi Y, Yamamoto M, Ohteki T. An early regulatory mechanism of hyperinflammation by restricting monocyte contribution. Front Immunol. 2024 Jul 8;15:1398153. http://doi.org/10.3389/fimmu.2024.1398153. PMID: 39040105; PMCID: PMC11260625.
Angele MK, Faist E. Clinical review: immunodepression in the surgical patient and increased susceptibility to infection. Crit Care. 2002 Aug;6(4):298-305. http://doi.org/10.1186/cc1514. Epub 2002 May 24. PMID: 12225603; PMCID: PMC137309.
Baddam S, Burns B. Systemic Inflammatory Response Syndrome. 2025 Jun 20. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan–. PMID: 31613449.
Bain CR, Myles PS, Corcoran T, Dieleman JM. Postoperative systemic inflammatory dysregulation and corticosteroids: a narrative review. Anaesthesia. 2023 Mar;78(3):356-370. http://doi.org/10.1111/anae.15896. Epub 2022 Oct 29. PMID: 36308338; PMCID: PMC10092416.
Buia A, Stockhausen F, Hanisch E. Laparoscopic surgery: A qualified systematic review. World J Methodol. 2015 Dec 26;5(4):238-54. http://doi.org/10.5662/wjm.v5.i4.238. PMID: 26713285; PMCID: PMC4686422.
Chadda KR, Puthucheary Z. Persistent inflammation, immunosuppression, and catabolism syndrome (PICS): a review of definitions, potential therapies, and research priorities. Br J Anaesth. 2024 Mar;132(3):507-518. http://doi.org/10.1016/j.bja.2023.11.052. Epub 2024 Jan 4. PMID: 38177003; PMCID: PMC10870139.
Chen L. Perioperative Inflammation and Immune Response in Anesthesia: Implications for Recovery and Postoperative Outcomes. J Cardiothorac Vasc Anesth. 2026 May;40(5):1511-1518. http://doi.org/10.1053/j.jvca.2025.11.013. Epub 2025 Nov 13. PMID: 41320622.
Dąbrowska AM, Słotwiński R. The immune response to surgery and infection. Cent Eur J Immunol. 2014;39(4):532-7. http://doi.org/10.5114/ceji.2014.47741. Epub 2014 Dec 15. PMID: 26155175; PMCID: PMC4439968.
Efron PA, Mohr AM, Bihorac A, et al. Persistent inflammation, immunosuppression, and catabolism and the development of chronic critical illness after surgery. Surgery. 2018 Aug;164(2):178-184. http://doi.org/10.1016/j.surg.2018.04.011. Epub 2018 May 26. PMID: 29807651; PMCID: PMC6056337.
Fagundes TR, Coradi C, Sotomayor MR, et al. Mechanisms of anesthetic-induced immune dysregulation. Anesthesiol Perioper Sci. 2025;3:37. http://doi.org/10.1007/s44254-025-00117-2.
Fajgenbaum DC, June CH. Cytokine Storm. N Engl J Med. 2020 Dec 3;383(23):2255-2273. http://doi.org/10.1056/NEJMra2026131. PMID: 33264547; PMCID: PMC7727315.
Fan JB, Li QY, Feng XF, et al. The «cytokine storm» in infection and sepsis: win the battle but lose the war. Mil Med Res. 2026 Jan 12;12(1):95. http://doi.org/10.1186/s40779-025-00678-0. PMID: 41521316; PMCID: PMC12794442.
Fernández-Martínez A, García JG, López-Picado A. Anti-Inflammatory and Immunomodulatory Effects of Intravenous Lidocaine in Surgery: A Narrative Review. J Clin Med. 2025 May 31;14(11):3883. http://doi.org/10.3390/jcm14113883. PMID: 40507646; PMCID: PMC12155905.
Furák J, Németh T, Lantos J, Fabó C, Géczi T, Zombori-Tóth N, Paróczai D, Szántó Z, Szabó Z. Perioperative Systemic Inflammation in Lung Cancer Surgery. Front Surg. 2022 May 20;9:883322. http://doi.org/10.3389/fsurg.2022.883322. PMID: 35669251; PMCID: PMC9163434.
Gentile LF, Cuenca AG, Efron PA, Ang D, Bihorac A, McKinley BA, Moldawer LL, Moore FA. Persistent inflammation and immunosuppression: a common syndrome and new horizon for surgical intensive care. J Trauma Acute Care Surg. 2012 Jun;72(6):1491-501. http://doi.org/10.1097/TA.0b013e318256e000. PMID: 22695412; PMCID: PMC3705923.
Gong N, Pan X, Deng Y, Che J, Bao J, Wang M, Xu C, Liu X, Shi Y. Immunosenescence: Molecular Mechanisms, Diseases, and Therapeutic Innovations. MedComm (2020). 2025 Dec 18;6(12):e70515. http://doi.org/10.1002/mco2.70515. PMID: 41427020; PMCID: PMC12715364.
Grauers Wiktorin H, Aydin E, et al. Impact of Surgery-Induced Myeloid-derived Suppressor Cells and the NOX2/ROS Axis on Postoperative Survival in Human Pancreatic Cancer. Cancer Res Commun. 2024 Apr 25;4(4):1135-1149. http://doi.org/10.1158/2767-9764.CRC-23-0447. PMID: 38598844; PMCID: PMC11044860.
Grosso F, Barbiani D, Cavalera C, Volpato E, Pagnini F. Risk factors associated with nocebo effects: A review of reviews. Brain Behav Immun Health. 2024 May 22;38:100800. http://doi.org/10.1016/j.bbih.2024.100800. PMID: 39021437; PMCID: PMC11252084.
Guo R, Yang WW, Zhong ML, Rao PG, Luo X, Liao BZ, Lei XH, Ye JM. The relationship between anesthesia, surgery and postoperative immune function in cancer patients: a review. Front Immunol. 2024 Sep 4;15:1441020. http://doi.org/10.3389/fimmu.2024.1441020. PMID: 39295870; PMCID: PMC11408194.
Halstead ES, McKeone DJ, Samuelsen AM, Zhou S, Bonavia AS. Functional immune profiling of hyper- and hypo-inflammatory subphenotypes of critical illness: a secondary analysis. Front Immunol. 2025 May 9;16:1520848. http://doi.org/10.3389/fimmu.2025.1520848. PMID: 40433392; PMCID: PMC12109463.
Hogan BV, Peter MB, Shenoy HG, Horgan K, Hughes TA. Surgery induced immunosuppression. Surgeon. 2011 Feb;9(1):38-43. http://doi.org/10.1016/j.surge.2010.07.011. Epub 2010 Sep 16. PMID: 21195330.
Hu Y, Zhang Y, Shi F, Yang R, Yan J, Han T, Guan L. Reversal of T-cell exhaustion: Mechanisms and synergistic approaches. Int Immunopharmacol. 2024 Sep 10;138:112571. http://doi.org/10.1016/j.intimp.2024.112571. Epub 2024 Jun 27. PMID: 38941674.
Jang JH. Extracellular Matrix in Human Disease and Therapy: From Pathogenic Remodeling to Biomaterial Platforms and Precision Diagnostics. Biomedicines. 2026 Jan 21;14(1):247. http://doi.org/10.3390/biomedicines14010247. PMID: 41595781; PMCID: PMC12839397.
Jankowski W, Mizielińska M, Nawrotek P. Microbiome and phageome: key factors in host organism function and disease prevention in the context of microbiome transplants. Applied Sciences. 2025;15(10):5330. http://doi.org/10.3390/app15105330.
Karpuzoglu E, Holladay SD, Gogal RM Jr. Inflammaging: triggers, molecular mechanisms, immunological consequences, sex differences, and cutaneous manifestations. Front Immunol. 2025 Dec 5;16:1704203. http://doi.org/10.3389/fimmu.2025.1704203. PMID: 41425557; PMCID: PMC12714610.
Kim M, Kim M, Jeong H, Chae JS, Kim YS, Lee JG, Cho Y, Lee JH. Hyporesponsiveness of natural killer cells and impaired inflammatory responses in critically ill patients. BMC Immunol. 2017 Dec 8;18(1):48. http://doi.org/10.1186/s12865-017-0231-y. PMID: 29221433; PMCID: PMC5723033.
Levett DZH, Grocott MPW. Prehabilitation: Impact on Postoperative Outcomes. Int Anesthesiol Clin. 2025 Jul 1;63(3):68-76. http://doi.org/10.1097/AIA.0000000000000481. Epub 2025 May 5. PMID: 40323728; PMCID: PMC12144543.
Li X, Lu Y, Chen C, Luo T, Chen J, Zhang Q, Zhou S, Hei Z, Liu Z. Development and validation of a patient-specific model to predict postoperative SIRS in older patients: A two-center study. Front Public Health. 2023 Apr 17;11:1145013. http://doi.org/10.3389/fpubh.2023.1145013. PMID: 37139371; PMCID: PMC10150121.
Li Y, Sun L, Zhou Q, Lee AJ, Wang L, Zhang R, Wang S. Effects of opioid drugs on immune function in cancer patients. Biomed Pharmacother. 2024 Jun;175:116665. http://doi.org/10.1016/j.biopha.2024.116665. Epub 2024 May 2. PMID: 38701564.
Lin H, Xiong W, Fu L, Yi J, Yang J. Damage-associated molecular patterns (DAMPs) in diseases: implications for therapy. Mol Biomed. 2025 Aug 29;6(1):60. http://doi.org/10.1186/s43556-025-00305-3. PMID: 40877572; PMCID: PMC12394712.
Liu S, Luo W, Szatmary P, Zhang X, Lin JW, Chen L, Liu D, Sutton R, Xia Q, Jin T, Liu T, Huang W. Monocytic HLA-DR Expression in Immune Responses of Acute Pancreatitis and COVID‑19. Int J Mol Sci. 2023 Feb 7;24(4):3246. http://doi.org/10.3390/ijms24043246. PMID: 36834656; PMCID: PMC9964039.
Luo YX, Matniyaz Y, Tang YX, et al. Postoperative hyper-inflammation as a predictor of poor outcomes in patients with acute type A aortic dissection (ATAAD) undergoing surgical repair. J Cardiothorac Surg. 2024 Mar 19;19(1):138. http://doi.org/10.1186/s13019-024-02637-7. PMID: 38504265; PMCID: PMC10949572.
Ma M, Jiang W, Zhou R. DAMPs and DAMP-sensing receptors in inflammation and diseases. Immunity. 2024 Apr 9;57(4):752-771. http://doi.org/10.1016/j.immuni.2024.03.002. PMID: 38599169.
Meizlish ML, Kimura Y, Pope SD, Matta R, Kim C, Philip NH, Meyaard L, Gonzalez A, Medzhitov R. Mechanosensing regulates tissue repair program in macrophages. Sci Adv. 2024 Mar 15;10(11):eadk6906. http://doi.org/10.1126/sciadv.adk6906. Epub 2024 Mar 13. PMID: 38478620; PMCID: PMC10936955.
Mira JC, Brakenridge SC, Moldawer LL, Moore FA. Persistent Inflammation, Immunosuppression and Catabolism Syndrome. Crit Care Clin. 2017 Apr;33(2):245-258. http://doi.org/10.1016/j.ccc.2016.12.001. PMID: 28284293; PMCID: PMC5351769.
Mokart D, Capo C, Blache JL, et al. Early postoperative compensatory anti-inflammatory response syndrome is associated with septic complications after major surgical trauma in patients with cancer. Br J Surg. 2002 Nov;89(11):1450-6. http://doi.org/10.1046/j.1365-2168.2002.02218.x. PMID: 12390391.
Monetta A, Griffoni C, Falzetti L, et al. Prolonged operative time significantly impacts on the incidence of complications in spinal surgery. J Orthop Surg Res. 2024 Sep 14;19(1):567. http://doi.org/10.1186/s13018-024-05066-3. PMID: 39272113; PMCID: PMC11401372.
Moris D, Barfield R, Chan C, et al. Immune phenotype and postoperative complications after elective surgery. Ann Surg. 2023 Dec;278(6):873-882. http://doi.org/10.1097/SLA.0000000000005864. PMID: 37051915.
Mu X, Li Y, Fan GC. Tissue-Resident Macrophages in the Control of Infection and Resolution of Inflammation. Shock. 2021 Jan 1;55(1):14-23. http://doi.org/10.1097/SHK.0000000000001601. PMID: 32590701; PMCID: PMC8859816.
Müller L, Di Benedetto S. Network Rewiring in the Aging Immune System: From Chronic Inflammation to Age-Related Pathologies. Cells. 2026 Feb 27;15(5):414. http://doi.org/10.3390/cells15050414. PMID: 41827848; PMCID: PMC12984825.
Ness S, Lin S, Gordon JR. Regulatory Dendritic Cells, T Cell Tolerance, and Dendritic Cell Therapy for Immunologic Disease. Front Immunol. 2021 Mar 10;12:633436. http://doi.org/10.3389/fimmu.2021.633436. PMID: 33777019; PMCID: PMC7988082.
Nikolouzakis TK, Alegakis A, Niniraki M, Kampa M, Chrysos E. Evaluation of the Diagnostic and Predictive Significance of Postoperative C-Reactive Protein to Transferrin or Albumin Ratio in Identifying Septic Events Following Major Abdominal Surgery. J Clin Med. 2025 Jun 18;14(12):4341. http://doi.org/10.3390/jcm14124341.
Novotny AR, Reim D, Assfalg V, et al. Mixed antagonist response and sepsis severity-dependent dysbalance of pro- and anti-inflammatory responses at the onset of postoperative sepsis. Immunobiology. 2012 Jun;217(6):616-21. http://doi.org/10.1016/j.imbio.2011.10.019. Epub 2011 Nov 3. PMID: 22204813.
Nuño-Pulido JJ, Gopar-Nieto R, Rojas-Velasco G, Manzur-Sandoval D. Systemic inflammatory response syndrome after cardiopulmonary bypass: prevalence, predictors, and outcomes. Rev Esp Anestesiol Reanim (Engl Ed). 2026 Mar;73(3):502021. http://doi.org/10.1016/j.redare.2026.502021. Epub 2026 Feb 7. PMID: 41663029.
Olson CP, Kennedy MI, DePhillipo NN, Tagliero AJ, LaPrade RF, Kennedy NI. Effect of anti-inflammatory treatments on patient outcomes and concentrations of inflammatory modulators in the post-surgical and post-traumatic tibiofemoral joint setting: a narrative review. Ann Jt. 2024 Jan 15;9:9. http://doi.org/10.21037/aoj-23-55.
Ostanin AA, Leplina OY, Shevela CY, Kozhevnikov VS, Chernykh HR. Inflammatory Syndromes (SIRS, MARS, CARS) in Patients with Surgical Infection. Russ J Immunol. 2000 Oct;5(3):289-300. PMID: 12687183.
Pang J, Koh TJ. Proliferation of monocytes and macrophages in homeostasis, infection, injury, and disease. J Leukoc Biol. 2023 Nov 24;114(6):532-546. http://doi.org/10.1093/jleuko/qiad093. PMID: 37555460; PMCID: PMC10673715.
Peh HY, Chen J. Pro-resolving lipid mediators and therapeutic innovations in resolution of inflammation. Pharmacol Ther. 2025 Jan;265:108753. http://doi.org/10.1016/j.pharmthera.2024.108753. Epub 2024 Nov 18. PMID: 39566561.
Peng B, Huang X, Xue Q, Tang J, Wan F, Peng Y, Jiang G, Zhou B. Dexmedetomidine reduces the inflammation level and morality in adult sepsis: a systemic review and meta-analysis based on randomized controlled trials. Front Med (Lausanne). 2025 Oct 21;12:1695924. http://doi.org/10.3389/fmed.2025.1695924. PMID: 41195185; PMCID: PMC12583032.
Polcz VE, Barrios EL, Larson SD, Efron PA, Rincon JC. Charting the course for improved outcomes in chronic critical illness: therapeutic strategies for persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Br J Anaesth. 2024 Aug;133(2):260-263. http://doi.org/10.1016/j.bja.2024.05.005. Epub 2024 Jun 19. PMID: 38902117.
Radkowski P, Pisula MJ, Malicki DK, et al. Review of the Effects of Anesthetic Techniques and Medications on the Immune Response During the Perioperative Period. Med Sci Monit. 2026 Mar 24;32:e951077. http://doi.org/10.12659/MSM.951077.
Rathod KS, Kapil V, Velmurugan S, et al. Accelerated resolution of inflammation underlies sex differences in inflammatory responses in humans. J Clin Invest. 2023 Jan 17;133(2):e168068. http://doi.org/10.1172/JCI168068. Erratum for: J Clin Invest. 2017 Jan 3;127(1):169-182. http://doi.org/10.1172/JCI89429. PMID: 36647837; PMCID: PMC9843040.
Reiff DD, Cron RQ. Cytokine Storm Syndrome Triggered by Extracorporeal Membrane Oxygenation in Pediatric Patients. Children (Basel). 2023 Jun 13;10(6):1052. http://doi.org/10.3390/children10061052. PMID: 37371283; PMCID: PMC10296981.
Reza T, Grezenko H, Barker C, et al. Emotional Stress and Immune Response in Surgery: A Psychoneuroimmunological Perspective. Cureus. 2023 Nov 13;15(11):e48727. http://doi.org/10.7759/cureus.48727. PMID: 38094516; PMCID: PMC10718057.20.
Reznik S, Tiwari A, Ashby C. Intravenous immunoglobulin: A potential treatment for the post-acute sequelae of SARS-Cov-2 infection? Bosn J Basic Med Sci. 2022 Jul 29;22(4):660-664. http://doi.org/10.17305/bjbms.2021.6901. PMID: 35150477; PMCID: PMC9392972.
Salimi M, Mosalamiaghili S, Mafhoumi A, Riaz M. The neutrophil-to-lymphocyte ratio (NLR) levels predicting the surgical site infection in spinal surgery: a systematic review. J Spine Surg. 2025 Mar 24;11(1):135-147. http://doi.org/10.21037/jss-24-106. Epub 2025 Mar 19. PMID: 40242815; PMCID: PMC11998054.
Sellmer L, Kovács J, Walter J, et al. Markers of Immune Cell Exhaustion as Predictor of Survival in Surgically-Treated Early-Stage NSCLC. Front Immunol. 2022 Jun 27;13:858212. http://doi.org/10.3389/fimmu.2022.858212. PMID: 35833140; PMCID: PMC9271570.
Shankar-Hari M, Francois B, Remy KE, et al. A randomized, double-blind, placebo-controlled trial of IL-7 in critically ill patients with COVID‑19. JCI Insight. 2025 Feb 4;10(6):e189150. http://doi.org/10.1172/jci.insight.189150. PMID: 39903535; PMCID: PMC11949036.
Sharma S, Gibbons A, Saphire EO. Sex differences in tissue-specific immunity and immunology. Science. 2025 Aug 7;389(6760):599-603. http://doi.org/10.1126/science.adx4381. Epub 2025 Aug 7. PMID: 40773572; PMCID: PMC12777860.
Shubin NJ, Monaghan SF, Ayala A. Anti-inflammatory mechanisms of sepsis. Contrib Microbiol. 2011;17:108-124. http://doi.org/10.1159/000324024. Epub 2011 Jun 9. PMID: 21659749.
Sikora JP, Karawani J, Sobczak J. Neutrophils and the Systemic Inflammatory Response Syndrome (SIRS). Int J Mol Sci. 2023 Aug 30;24(17):13469. http://doi.org/10.3390/ijms241713469. PMID: 37686271; PMCID: PMC10488036.
Silva EE, Skon-Hegg C, Badovinac VP, Griffith TS. The Calm after the Storm: Implications of Sepsis Immunoparalysis on Host Immunity. J Immunol. 2023 Sep 1;211(5):711-719. http://doi.org/10.4049/jimmunol.2300171. PMID: 37603859; PMCID: PMC10449360.
Sim J, O’Guin E, Sugimoto C, et al. Monocyte-derived IL-10 drives sex differences in pain duration. Sci Immunol. 2026 Feb 20;11(116):eadx0292. http://doi.org/10.1126/sciimmunol.adx0292. Epub 2026 Feb 20. PMID: 41719383.
Smajic J, Tupkovic LR, Husic S, Avdagic SS, Hodzic S, Imamovic S. Systemic Inflammatory Response Syndrome in Surgical Patients. Med Arch. 2018 Apr;72(2):116-119. http://doi.org/10.5455/medarh.2018.72.116-119. PMID: 29736100; PMCID: PMC5911168.
Snow TAC, Waller AV, Loye R, et al.; University College London Hospitals Critical Care Research Team. Early dynamic changes to monocytes following major surgery are associated with subsequent infections. Front Immunol. 2024 Apr 9;15:1352556. http://doi.org/10.3389/fimmu.2024.1352556. PMID: 38655251; PMCID: PMC11035723.
Song Y, Mo Y, Chen S, Chen Y, Zhang C, Deng S, Liao J, He Y, Wang W, Zheng W, Zeng T. Immune Exhaustion in Chronic Infection and Cancer: Signaling Pathways and Therapeutic Interventions. MedComm (2020). 2026 Feb 26;7(3):e70635. http://doi.org/10.1002/mco2.70635. PMID: 41768369; PMCID: PMC12946661.
Stoppelkamp S, Veseli K, Stang K, Schlensak C, Wendel HP, Walker T. Identification of Predictive Early Biomarkers for Sterile-SIRS after Cardiovascular Surgery. PLoS One. 2015 Aug 11;10(8):e0135527. http://doi.org/10.1371/journal.pone.0135527. PMID: 26263001; PMCID: PMC4532358.
Sturm R, Xanthopoulos L, Heftrig D, et al. Regulatory T Cells Modulate CD4 Proliferation after Severe Trauma via IL-10. J Clin Med. 2020 Apr 8;9(4):1052. http://doi.org/10.3390/jcm9041052. PMID: 32276346; PMCID: PMC7230720.
Susak YM, Dirda OO, Fedorchuk OG, Tkachenko OA, Skivka LM. Infectious Complications of Acute Pancreatitis Is Associated with Peripheral Blood Phagocyte Functional Exhaustion. Dig Dis Sci. 2021 Jan;66(1):121-130. http://doi.org/10.1007/s10620-020-06172-y. Epub 2020 Mar 13. PMID: 32170475.
Valsamaki A, Vazgiourakis V, Mantzarlis K, Manoulakas E, Makris D. Immune Dysregulation in Sepsis. A Narrative Review for the Clinicians. Biomedicines. 2025 Sep 29;13(10):2386. http://doi.org/10.3390/biomedicines13102386. PMID: 41153671; PMCID: PMC12561552.
Van Amstel RBE, Bartek B, Vlaar APJ, et al. Temporal Transitions of the Hyperinflammatory and Hypoinflammatory Phenotypes in Critical Illness. Am J Respir Crit Care Med. 2025 Mar;211(3):347-356. http://doi.org/10.1164/rccm.202406-1241OC. PMID: 39642348; PMCID: PMC11936145.
Verdonk F, Einhaus J, Tsai AS, et al. Measuring the human immune response to surgery: multiomics for the prediction of postoperative outcomes. Curr Opin Crit Care. 2021 Dec 1;27(6):717-725. http://doi.org/10.1097/MCC.0000000000000883. PMID: 34545029; PMCID: PMC8585713.
Volkovetskii V, Lobanova O, Puzyr N, et al. Laparoscopic common bile duct exploration vs endoscopic retrograde cholangiopancreatography for the treatment of difficult common bile duct stones: postsurgery inflammation and liver function. J Gastrointest Surg. 2025 Sep;29(9):102156. http://doi.org/10.1016/j.gassur.2025.102156. Epub 2025 Jul 17. PMID: 40683590.
Volkovetskii VV, Lobanova OM, Puzyr NV, et al. Dynamic changes in inflammatory indices after laparoscopic common bile duct exploration in male and female patients with complex common bile duct stones. Biotechnol Acta. 2025;18(3):50-57. http://doi.org/10.15407/biotech18.03.050.
Ward NS, Casserly B, Ayala A. The compensatory anti-inflammatory response syndrome (CARS) in critically ill patients. Clin Chest Med. 2008 Dec;29(4):617-25, viii. http://doi.org/10.1016/j.ccm.2008.06.010. PMID: 18954697; PMCID: PMC2786900.
Wu Y, Wang L, Li Y, Cao Y, Wang M, Deng Z, Kang H. Immunotherapy in the context of sepsis-induced immunological dysregulation. Front Immunol. 2024 May 21;15:1391395. http://doi.org/10.3389/fimmu.2024.1391395. PMID: 38835773; PMCID: PMC11148279.
Xiong D, Geng H, Lv X, Wang S, Jia L. Inflammatory Response and Anti-Inflammatory Treatment in Persistent Inflammation-Immunosuppression-Catabolism Syndrome (PICS). J Inflamm Res. 2025 Feb 14;18:2267-2281. http://doi.org/10.2147/JIR.S504694. PMID: 39968098; PMCID: PMC11834740.
Yang YW, Wu CH, Tsai HT, Chen YR, Chang YP, Han YY, Wu TE, Hu RH. Dynamics of immune responses are inconsistent when trauma patients are grouped by injury severity score and clinical outcomes. Sci Rep. 2023 Jan 25;13(1):1391. http://doi.org/10.1038/s41598-023-27969-7. PMID: 36697474; PMCID: PMC9876923.
Yu D, Xu C, Jiang J, Shen W, Zhu H. How do mechanical forces impact macrophages in the processes of mechanosensing and mechanotransduction? J Zhejiang Univ Sci B. 2025 Dec 10;27(2):129-148. http://doi.org/10.1631/jzus.B2400183. PMID: 41657064; PMCID: PMC12885616.
Zhang B, Xiao Q, Ma Q, Han L. Clinical treatment for persistent inflammation, immunosuppression and catabolism syndrome in patients with severe acute pancreatitis (Review). Exp Ther Med. 2023 Sep 6;26(4):495. http://doi.org/10.3892/etm.2023.12194. PMID: 37753297; PMCID: PMC10519614.
Zhao D, Yang R, Liu S, Ge D, Su X. Study on the Characteristics of Early Cytokine Storm Response to Cardiac Surgery. J Interferon Cytokine Res. 2023 Aug;43(8):351-358. http://doi.org/10.1089/jir.2023.0044. PMID: 37566476.
Zhao-Fleming H, Hand A, Zhang K, Polak R, Northcut A, Jacob D, Dissanaike S, Rumbaugh KP. Effect of non-steroidal anti-inflammatory drugs on post-surgical complications against the backdrop of the opioid crisis. Burns Trauma. 2018 Sep 13;6:25. http://doi.org/10.1186/s41038-018-0128-x. PMID: 30221175; PMCID: PMC6136175.
Zheng X, Guo H, Zhang J, Lei M, Chou S, Liu Y, Luo L. Sepsis biomarkers: recent advances and future perspectives. Front Immunol. 2026 Mar 19;17:1734588. http://doi.org/10.3389/fimmu.2026.1734588. PMID: 41939863; PMCID: PMC13044059.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Authors
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
