Abstract
A disorder of the immune mechanisms of innate and adaptive immunity, inadequate inflammatory response and/or immunoparalysis are the drivers of the search for an effective immunomodulatory treatment in septic patients. During the last 30 years various approaches have been tried without substantial effect.
Immunomodulatory therapy involves anti-inflammatory treatment - with intravenous immunoglobulins, corticosteriods, therapy targeting the inflammatory cascade - cytokine inhibitors or inhibitors of Toll-like receptor mechanism of recognition. On the other hand there is immunostimulatory therapy whose repertoire is significantly smaller - growth factors or leukocyte dialyzate.
The current knowledge of the immunopathogenesis of sepsis shows the dominance of immunosuppression in septic patients. The promising results of using immunomodulatory therapy in experimental studies have not been confirmed in clinical trials.
Immunotherapy of sepsis could represent the "magic bullet" that has not yet been found.