Is the developmentally immature immune response in paediatric sepsis a recapitulation of immune tolerance?

Summary Immunologically immature neonates suffer the highest incidence of paediatric sepsis. Postnatal immunological maturation is characterized by a relatively hypo‐inflammatory immune response. The mechanisms that differentiate the mature and immature immune responses resemble those that differentiate the hyper‐ and hypo‐inflammatory responses in severe sepsis. Immunological maturational differences likely affect the neonate's ability to mount an appropriate hyper‐inflammatory response, a counteractive hypo‐inflammatory response, and subsequent return to immune system homeostasis. To better understand the role of the hypo‐inflammatory response in paediatric sepsis, we will explore the maturation of the immune system and the effect it may have on the sepsis‐induced hypo‐inflammatory response.