ArticleIntensive care medicine2026
Measuring signatures of host resistance, disease tolerance, and damage in human sepsis: a prospective cohort study.
Article in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Reframing sepsis through resistance, disease tolerance and damage: a clinically meaningful conceptual shift?Intensive care medicine · 2026Article
- Dynamic prognostic prediction in sepsis using longitudinal blood gas trajectories: development and external validation.Frontiers in medicine · 2026Article
- Crosstalk between innate immune signaling pathways and integrated TLR, NLRP3 inflammasome, cGAS-STING, and NF-κB networks in sepsis.Frontiers in cell and developmental biology · 2026Review
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Authors and funding
11 authors.
Funding
Abstract
purposeTo understand how protein biomarkers in blood and urine that are aligned with host resistance to infection, disease tolerance, and damage are associated with clinical outcomes and sepsis subtypes in community-onset sepsis.
methodsAdults meeting Sepsis-3 criteria were prospectively enrolled within 6 h of emergency department arrival and assigned clinical subtypes (α, β, γ, δ), using the Sepsis ENdotyping in Emergency CAre (SENECA) approach. Using structured expert ranking with consensus adjudication, 16 plasma and urinary biomarkers obtained from remnant biospecimens were grouped into three mechanistic axes contributing to sepsis pathophysiology: host resistance to infection, disease tolerance, and damage to the host. Biomarkers for each concept were analyzed with principal component analysis as a signature, and multivariable logistic regression tested associations of each signature with 90-day mortality and sepsis subtype membership.
resultsAmong 444 adults, the mean age was 60 years [SD: 16], the mean SOFA score was 4.3 [SD: 2.3], and 90-day mortality was 17%. After adjustment for age, sex, and race, greater damage to the host was associated with increased 90-day mortality (adjusted odds ratio (aOR) = 1.70; 95% CI 1.38-2.11; p < 0.001), while greater host resistance (aOR = 0.83; 95% CI 0.54-1.10; p = 0.4) and greater disease tolerance (aOR = 0.83; 95% CI 0.68-1.01; p = 0.06) were not. Differences across sepsis subtypes were most pronounced for disease tolerance and damage signatures, where the δ‑type patients exhibited higher damage and lower disease tolerance and the α‑type patients had lower damage and higher disease tolerance.
conclusionBiomarker signatures aligned with host resistance to infection, disease tolerance, and damage to the host, informed by expert consensus, were associated with clinical outcomes and sepsis subtype membership.
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