Beyond immunosuppression: decoding systemic immune dysregulation in ICU-acquired pneumonia

Intensive care unit (ICU)-acquired pneumonia, either ventilator-associated or hospital-acquired, represents a major clinical challenge that is associated with high mortality, prolonged hospitalisations, and increased cost [1, 2]. Prior research has focused on immunosuppression as the primary driver of infection susceptibility; however, clinical trials of immunostimulatory agents have been largely unsuccessful, suggesting that the pathogenesis of ICU-acquired pneumonia is more complex than previously appreciated [3–5].