29th International Symposium on Infections in the Critically Ill Patient (ISICIP 2025)
At the 29th International Symposium on Infections in the Critically Ill Patient (ISICIP 2025), one of the most anticipated sessions of the meeting was held: “NLRP3 Inflammasome: The Missing Link in Sepsis Survival.” You can read the full transcription of the session “NLRP3 Inflammasome: The Missing Link in Sepsis Survival” in this article, which includes the complete presentations and discussion from ISICIP 2025
Organized in collaboration with Viva In Vitro Diagnostics, the session brought together three leading figures in sepsis research and clinical care: Dr. Ricard Ferrer Roca (Vall d’Hebron University Hospital), Prof. Evangelos Giomarellos (University of Athens), and Prof. Pablo Pelegrín (University of Murcia, IMIB, and co-founder of Viva In Vitro Diagnostics).
A new approach to the immune response in sepsis
The discussion focused on a key concept: understanding the role of the NLRP3 inflammasome, a molecular complex that acts as a sensor for the innate immune system.
When properly regulated, the NLRP3 inflammasome triggers essential inflammatory responses to infections. However, when dysregulated, it can contribute to critical phenomena such as macrophage activation syndrome and the so-called cytokine storm, both associated with severe outcomes in septic patients.
Prof. Giomarellos presented different clinical phenotypes of sepsis identified through analyses of large international cohorts. Among them, he highlighted the delta phenotype, linked to worse prognosis despite showing similar levels of inflammatory biomarkers (IL-6, CRP, ferritin). This finding suggests that sepsis severity cannot be explained by biomarker concentrations alone — instead, it reflects differences in immune function.
From the laboratory to clinical practice
In his presentation, Prof. Pablo Pelegrín addressed this gap between measuring inflammation and understanding immune function.
Through the technology developed by Viva In Vitro —the VIVA-ELISA® test, which measures the activation of the NLRP3 inflammasome in immune cells from patient blood samples— he demonstrated how it is possible to detect immune paralysis early, even when traditional inflammatory biomarkers remain elevated.
These patients show an inability of their immune cells (monocytes) to respond to new infections, a condition associated with higher mortality, longer ICU stays, and a greater risk of reinfection after hospital discharge.
The study also revealed that this dysfunction is transient and reversible, opening the door to personalized treatment strategies and a new clinical parameter for assessing discharge readiness.
A step forward toward precision medicine in sepsis
Session moderator Dr. Ferrer emphasized the clinical relevance of these findings:
“Identifying patients with immunological fragility after the acute phase is essential. We need to integrate molecular biology into clinical decision-making to improve not only survival, but also long-term recovery.”
The session concluded with a clear consensus: measuring NLRP3 inflammasome function could become a key tool to personalize sepsis treatment and prevent post-ICU complications.
At Viva In Vitro Diagnostics, we continue to bridge science and clinical practice, developing innovative solutions that help detect sepsis before it becomes critical and improve patient outcomes worldwide.