脓毒症仍然是低收入和高收入国家发病和死亡的主要原因。二十世纪，抗生素治疗和支持治疗显着改善了脓毒症后的生存率，但进一步的进展仍然充满挑战。自 20 世纪 90 年代和 2000 年代以来，主要旨在抑制免疫反应的脓毒症免疫治疗试验基本上失败了，部分原因是潜在免疫失衡中尚未解决的患者异质性。过去十年，基于组学技术和系统医学的技术发展有望打破这一封锁，这些技术和系统医学可以提供更大的数据空间来更详细地描述脓毒症的免疫内型。患者分层为精准医学方法开辟了新途径，旨在以精确的生物标志物和定义特定免疫内型的分子机制为基础，将免疫疗法应用于脓毒症。这种方法有可能使免疫疗法成为后代治疗脓毒症的成功支柱。

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Sepsis remains a major cause of morbidity and mortality in both low- and high-income countries. Antibiotic therapy and supportive care have significantly improved survival following sepsis in the twentieth century, but further progress has been challenging. Immunotherapy trials for sepsis, mainly aimed at suppressing the immune response, from the 1990s and 2000s, have largely failed, in part owing to unresolved patient heterogeneity in the underlying immune disbalance. The past decade has brought the promise to break this blockade through technological developments based on omics-based technologies and systems medicine that can provide a much larger data space to describe in greater detail the immune endotypes in sepsis. Patient stratification opens new avenues towards precision medicine approaches that aim to apply immunotherapies to sepsis, on the basis of precise biomarkers and molecular mechanisms defining specific immune endotypes. This approach has the potential to lead to the establishment of immunotherapy as a successful pillar in the treatment of sepsis for future generations.