# Sepsis modelling: current approaches and organ-on-chip perspectives

**Authors:** Mariana J. Silva, Gustavo W. Fehrenbach, Robert Pogue, Patrick Murray, Emanuele Rezoagli, John G. Laffey, Emma J. Murphy

PMC · DOI: 10.1016/j.ebiom.2026.106120 · 2026-02-14

## TL;DR

This review explores current methods and future directions in sepsis modeling, emphasizing the potential of organ-on-chip technology to improve translational research.

## Contribution

The paper provides a structured comparison of sepsis models and highlights organ-on-chip systems as a promising approach for capturing human physiology.

## Key findings

- Current sepsis models have limitations in complexity and reproducibility, hindering clinical translation.
- Organ-on-chip systems offer a more accurate representation of human physiology and sepsis features.
- Integrating advanced models could enhance therapeutic discovery and model selection for specific research questions.

## Abstract

Sepsis is a complex life-threatening condition involving immune dysregulation, endothelial dysfunction, and multi-organ failure. To investigate molecular and systemic processes driving disease progression, in vitro, in vivo, and ex vivo experimental methods have been developed. While these systems have advanced understanding of immune activation, cytokine signalling, and organ injury, differences in complexity, reproducibility, and alignment with human pathophysiology have limited the translation of many promising preclinical findings into clinical success. This review examines current literature on sepsis systems, evaluating them in terms of biological complexity, reproducibility, ethical constraints, and clinical applicability. In parallel, it discusses the potential use of microfluidic technology, particularly organ-on-chip, in replicating human physiology and capturing key features of sepsis. By comparing conventional and advanced systems, this review outlines challenges in sepsis research and identifies key directions for a more integrated approach to sepsis modelling, aiming to improve translational outcomes and therapeutic discovery. We aim to provide a structured basis for comparing models when selecting approaches for a given question or candidate therapy.

## Full-text entities

- **Genes:** Il2 (interleukin 2) [NCBI Gene 16183] {aka Il-2}, IFNG (interferon gamma) [NCBI Gene 3458] {aka IFG, IFI, IMD69}, APOB (apolipoprotein B) [NCBI Gene 338] {aka FCHL2, FLDB, LDLCQ4, apoB-100, apoB-48}, Nfkbia (nuclear factor of kappa light polypeptide gene enhancer in B cells inhibitor, alpha) [NCBI Gene 18035] {aka Nfkbi}, CDH5 (cadherin 5) [NCBI Gene 1003] {aka 7B4, CD144}, LY96 (lymphocyte antigen 96) [NCBI Gene 23643] {aka ESOP-1, MD-2, MD2, ly-96}, Hmgb1 (high mobility group box 1) [NCBI Gene 15289] {aka HMG-1, Hmg1, SBP-1, p30}, P2RX7 (purinergic receptor P2X 7) [NCBI Gene 5027] {aka P2X7}, Il6 (interleukin 6) [NCBI Gene 16193] {aka Il-6}, IL18 (interleukin 18) [NCBI Gene 3606] {aka IGIF, IL-18, IL-1g, IL1F4}, TLR1 (toll like receptor 1) [NCBI Gene 7096] {aka CD281, TIL, TIL. LPRS5, rsc786}, CXCL8 (C-X-C motif chemokine ligand 8) [NCBI Gene 3576] {aka GCP-1, GCP1, IL8, LECT, LUCT, LYNAP}, PROC (protein C, inactivator of coagulation factors Va and VIIIa) [NCBI Gene 5624] {aka APC, PC, PROC1, THPH3, THPH4}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, ANGPT2 (angiopoietin 2) [NCBI Gene 285] {aka AGPT2, ANG2, LMPHM10}, IL12B (interleukin 12B) [NCBI Gene 3593] {aka CLMF, CLMF2, IL-12B, IMD28, IMD29, NKSF}, Ifng (interferon gamma) [NCBI Gene 15978] {aka IFN-g, If2f, Ifg}, ICAM1 (intercellular adhesion molecule 1) [NCBI Gene 3383] {aka BB2, CD54, P3.58}, ALB (albumin) [NCBI Gene 213] {aka FDAHT, HSA, PRO0883, PRO0903, PRO1341}, CCL2 (C-C motif chemokine ligand 2) [NCBI Gene 6347] {aka GDCF-2, HC11, HSMCR30, MCAF, MCP-1, MCP1}, IL1RN (interleukin 1 receptor antagonist) [NCBI Gene 3557] {aka CRMO2, DIRA, ICIL-1RA, IL-1RN, IL-1ra, IL-1ra3}, CD14 (CD14 molecule) [NCBI Gene 929], CASP1 (caspase 1) [NCBI Gene 834] {aka ICE, IL1BC, P45}, SELP (selectin P) [NCBI Gene 6403] {aka CD62, CD62P, GMP140, GRMP, LECAM3, PADGEM}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, CALML3 (calmodulin like 3) [NCBI Gene 810] {aka CLP}, ABCC2 (ATP binding cassette subfamily C member 2) [NCBI Gene 1244] {aka ABC30, CMOAT, DJS, MRP2, cMRP}, Tnf (tumor necrosis factor) [NCBI Gene 21926] {aka DIF, TNF-a, TNF-alpha, TNFSF2, TNFalpha, Tnfa}, TLR2 (toll like receptor 2) [NCBI Gene 7097] {aka CD282, TIL4}, NR1I2 (nuclear receptor subfamily 1 group I member 2) [NCBI Gene 8856] {aka BXR, ONR1, PAR, PAR1, PAR2, PARq}, Mapk14 (mitogen-activated protein kinase 14) [NCBI Gene 26416] {aka CSBP2, Crk1, Csbp1, Mxi2, PRKM14, PRKM15}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, IL1A (interleukin 1 alpha) [NCBI Gene 3552] {aka IL-1 alpha, IL-1A, IL1, IL1-ALPHA, IL1F1}, TLR4 (toll like receptor 4) [NCBI Gene 7099] {aka ARMD10, CD284, TLR-4, TOLL}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, PPIG (peptidylprolyl isomerase G) [NCBI Gene 9360] {aka CARS-Cyp, CYP, SCAF10, SRCyp}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, NLRP3 (NLR family pyrin domain containing 3) [NCBI Gene 114548] {aka AGTAVPRL, AII, AVP, C1orf7, CIAS1, CLR1.1}, IRF3 (interferon regulatory factor 3) [NCBI Gene 3661] {aka IIAE7}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, Cirbp (cold inducible RNA binding protein) [NCBI Gene 12696] {aka Cirp}
- **Diseases:** immune dysregulation (OMIM:614878), septic shock (MESH:D012772), ARDS (MESH:D012128), intestinal injury (MESH:D007410), coma (MESH:D003128), CASP (MESH:D003110), Sepsis (MESH:D018805), infectious (MESH:D003141), analgesia (MESH:D000699), organ damage (MESH:D000092124), Organ Dysfunction (MESH:D009102), tachycardia (MESH:D013610), abdominal infection (MESH:D000007), acute systemic (MESH:D040701), intoxication (MESH:D000435), delirium (MESH:D003693), myalgia (MESH:D063806), pneumonia (MESH:D011014), confusion (MESH:D003221), liver dysfunction (MESH:D017093), dysfunction (MESH:D006331), Systemic Inflammatory Response Syndrome (MESH:D018746), Infection (MESH:D007239), endothelial dysfunction (MESH:D014652), COVID 19 (MESH:D000086382), immune dysfunction (MESH:D007154), cancer (MESH:D009369), peritonitis (MESH:D010538), endothelial injury (MESH:D057772), urinary tract infections (MESH:D014552), weight loss (MESH:D015431), neuroinflammatory (MESH:D000090862), trauma (MESH:D014947), bacteraemia (MESH:C531821), shock (MESH:D012769), inflammation (MESH:D007249), secondary infections (MESH:D060085), headache (MESH:D006261), critical illness (MESH:D016638), pain (MESH:D010146), encephalopathy (MESH:D001927), deaths (MESH:D003643)
- **Chemicals:** NAD+ (MESH:D009243), lipid A (MESH:D008050), imipenem (MESH:D015378), ATP (MESH:D000255), phospholipids (MESH:D010743), LPS (MESH:D008070), TAK 242 (MESH:C507035), cortisol (MESH:D006854), lipoteichoic acid (MESH:C009900), ICG (MESH:D007208), BioRender (-), sugars (MESH:D000073893), silica (MESH:D012822), ammonia (MESH:D000641), glycerol (MESH:D005990), O antigen (MESH:D019081), oxygen (MESH:D010100)
- **Species:** Streptococcus pyogenes (species) [taxon 1314], Sus scrofa (pig, species) [taxon 9823], Oryctolagus cuniculus (domestic rabbit, species) [taxon 9986], Ovis aries (domestic sheep, species) [taxon 9940], Pseudomonas (RNA similarity group I, genus) [taxon 286], Rattus norvegicus (brown rat, species) [taxon 10116], Staphylococcus aureus (species) [taxon 1280], Mus musculus (house mouse, species) [taxon 10090], Bacteria Latreille et al. 1825 (Bacteria stick insect, genus) [taxon 629395], Klebsiella pneumoniae (species) [taxon 573], Canis lupus familiaris (dog, subspecies) [taxon 9615], Cricetinae (hamsters, subfamily) [taxon 10026], Homo sapiens (human, species) [taxon 9606], Escherichia coli (E. coli, species) [taxon 562]
- **Cell lines:** A549 — Homo sapiens (Human), Lung adenocarcinoma, Cancer cell line (CVCL_0023), THP-1 — Homo sapiens (Human), Childhood acute monocytic leukemia, Cancer cell line (CVCL_0006), HepG2 — Homo sapiens (Human), Hepatoblastoma, Cancer cell line (CVCL_0027)

## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12925287/full.md

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Source: https://tomesphere.com/paper/PMC12925287