PRRs are grouped into five main families: toll-like receptors (TLRs), NOD-like receptors, C-type lectins, scavenger receptors, RIG-I-like receptors, and intra-cytosolic DNA sensors ( 3). Innate immune cells, such as monocytes/macrophages, dendritic cells (DCs), and neutrophils, sense microbial and danger-associated molecular patterns (MAMPs produced by microorganisms, and DAMPs released by injured or stressed cells) through pattern recognition receptors (PRRs). In 2017, the World Health Assembly and the World Health Organization made sepsis a global health priority by adopting a resolution to improve the prevention, diagnosis, and management of sepsis. Sepsis incidence is rising due to the aging of the population, the burden of chronic diseases, the increasing number of immunocompromised patients, and the resistance of microorganisms to antimicrobials ( 2). The mortality rate of sepsis accounts for five-to-six million deaths of ~30 million cases per year worldwide. Sepsis is defined as a “life-threatening organ dysfunction caused by a dysregulated host response to infection” ( 1). Sepsis is one of the leading causes of preventable death. While some key aspects of MDSCs biology need in depth investigations, exploring these avenues may participate to pave the way toward the implementation of personalized medicine and precision immunotherapy for patients suffering from sepsis. Blocking MDSC-mediated immunosuppression and trafficking or depleting MDSCs might all improve sepsis outcome. Hence, MDSCs are attractive biomarkers and therapeutic targets for sepsis, especially because these cells are barely detectable in healthy subjects. Strikingly, all clinical studies to date suggest that high proportions of blood MDSCs are associated with clinical worsening, the incidence of nosocomial infections and/or mortality. Here we discuss the mechanisms underlying the expansion and immunosuppressive functions of MDSCs, and the results of preclinical and clinical studies linking MDSCs to sepsis pathogenesis. Recent studies uncovered an important role of MDSCs in the pathogenesis of infectious diseases along with sepsis. MDSCs expand during chronic and acute inflammatory conditions, the best described being cancer. Myeloid-derived suppressor cells (MDSCs) are immature myeloid cells characterized by their immunosuppressive functions.
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