Sepsis and multiple sclerosis: Causative links and outcomes

Immunol Lett. 2021 Oct;238:40-46. doi: 10.1016/j.imlet.2021.07.008. Epub 2021 Jul 25.


Sepsis is a life-threatening condition characterized by an acute cytokine storm followed by prolonged dysfunction of the immune system in the survivors. Post-septic lymphopenia and functional deficits of the remaining immune cells lead to increased susceptibility to secondary infections and other morbid conditions causing late death in the patients. This state of post-septic immunoparalysis may also influence disorders stemming from inappropriate or overactive immune responses, such as autoimmune and immunoinflammatory diseases, including multiple sclerosis. In addition, ongoing autoimmunity likely influences the susceptibility to and outcome of sepsis. This review article addresses the bidirectional relationship between sepsis and multiple sclerosis, with a focus on the immunologic mechanisms of the interaction and potential directions for future studies.

Keywords: Gut microbiota; Multiple sclerosis; Sepsis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Biomarkers
  • Brain-Gut Axis / immunology
  • Disease Susceptibility* / immunology
  • Gastrointestinal Microbiome / immunology
  • Humans
  • Immune System / immunology
  • Immune System / metabolism
  • Multiple Sclerosis / diagnosis
  • Multiple Sclerosis / etiology*
  • Multiple Sclerosis / metabolism
  • Neuroimmunomodulation
  • Organ Specificity / immunology
  • Sepsis / diagnosis
  • Sepsis / etiology*
  • Sepsis / metabolism


  • Biomarkers