{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:39:09Z","timestamp":1791581949682,"version":"4.3.4"},"reference-count":181,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Sepsis-induced immunoparalysis is a dynamic state of acquired immune dysfunction characterized by impaired antigen presentation, lymphocyte exhaustion, defective innate immune responses, and increased susceptibility to secondary infection. Increasing evidence suggests that mitochondrial dysfunction is a key metabolic mechanism underlying this immune failure. Rather than acting as a uniform injury signal, mitochondrial abnormalities affect immune-cell subsets in distinct ways: monocytes and macrophages lose antigen-presenting capacity, neutrophils develop impaired migration and antimicrobial activity, T cells acquire exhaustion-like phenotypes, and NK and B-cell responses become functionally constrained. This review summarizes how core mitochondrial processes, including bioenergetic failure, redox imbalance, mitochondrial danger-signal release, and defective quality control, contribute to sepsis-induced immunoparalysis. We further discuss how mitochondria-related readouts may complement established immune markers such as monocyte HLA-DR, lymphocyte count, PD-1\/PD-L1, CD86, and IL-10 for patient stratification. Finally, we highlight therapeutic opportunities aimed at restoring mitochondrial fitness and immune competence in biomarker-defined septic patients.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1904513","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:38:08Z","timestamp":1785497888000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mitochondrial dysfunction in sepsis-induced immunoparalysis: from immune-cell metabolic reprogramming to clinical biomarkers"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiaxin","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China","place":["Chengdu, China"]},{"name":"Department of Critical Care Medicine, The Second Affiliated Hospital of Chongqing 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