Go to JCI Insight
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
  • Clinical Research and Public Health
  • Current issue
  • Past issues
  • By specialty
    • COVID-19
    • Cardiology
    • Gastroenterology
    • Immunology
    • Metabolism
    • Nephrology
    • Neuroscience
    • Oncology
    • Pulmonology
    • Vascular biology
    • All ...
  • Videos
    • ASCI Milestone Awards
    • Video Abstracts
    • Conversations with Giants in Medicine
  • Reviews
    • View all reviews ...
    • The cGAS-STING pathway: DNA sensing in health and disease (Jun 2026)
    • Neurodegeneration (Mar 2026)
    • Clinical innovation and scientific progress in GLP-1 medicine (Nov 2025)
    • Pancreatic Cancer (Jul 2025)
    • Complement Biology and Therapeutics (May 2025)
    • Evolving insights into MASLD and MASH pathogenesis and treatment (Apr 2025)
    • Microbiome in Health and Disease (Feb 2025)
    • View all review series ...
  • Viewpoint
  • Collections
    • In-Press Preview
    • Clinical Research and Public Health
    • Research Letters
    • Letters to the Editor
    • Editorials
    • Commentaries
    • Editor's notes
    • Reviews
    • Viewpoints
    • 100th anniversary
    • Top read articles

  • Current issue
  • Past issues
  • Specialties
  • Reviews
  • Review series
  • ASCI Milestone Awards
  • Video Abstracts
  • Conversations with Giants in Medicine
  • In-Press Preview
  • Clinical Research and Public Health
  • Research Letters
  • Letters to the Editor
  • Editorials
  • Commentaries
  • Editor's notes
  • Reviews
  • Viewpoints
  • 100th anniversary
  • Top read articles
  • About
  • Editors
  • Consulting Editors
  • For authors
  • Publication ethics
  • Publication alerts by email
  • Advertising
  • Job board
  • Contact
Top
  • View PDF
  • Download citation information
  • Send a comment
  • Terms of use
  • Standard abbreviations
  • Need help? Email the journal
  • Top
  • Abstract
  • Supplemental material
  • Version history
  • Article usage
  • Citations to this article

Advertisement

Clinical Research and Public HealthIn-Press PreviewClinical ResearchImmunologyInflammation Open Access | 10.1172/JCI202867

Aberrant STAT signaling and T cell dysregulation define a targetable pediatric sepsis endotype

Robert B. Lindell,1 Samir U. Sayed,2 Jose S. Campos Duran,2 Sydney A. Sheetz,3 Apoorva Babu,4 Montana S. Knight,4 Andrea A. Mauracher,2 Ceire A. Hay,2 Peyton E. Conrey,2 Julie C. Fitzgerald,1 Nadir Yehya,1 Stephen T. Famularo III,3 Teresa Arroyo,3 Richard Tustin III,2 Hossein Fazelinia,5 Edward M. Behrens,6 David T. Teachey,7 Lisa R. Forbes Satter,8 Alexandra F. Freeman,9 Jenna R.E. Bergerson,9 Steven M. Holland,9 Jennifer W. Leiding,10 Scott L. Weiss,11 Mark W. Hall,12 Deanne M. Taylor,13 Rui Feng,14 E. John Wherry,15 Nuala J. Meyer,15 and Sarah E. Henrickson16

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Lindell, R. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Sayed, S. in: PubMed | Google Scholar |

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Campos Duran, J. in: PubMed | Google Scholar |

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Sheetz, S. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Babu, A. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Knight, M. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Mauracher, A. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Hay, C. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Conrey, P. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Fitzgerald, J. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Yehya, N. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Famularo III, S. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Arroyo, T. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Tustin III, R. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Fazelinia, H. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Behrens, E. in: PubMed | Google Scholar |

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Teachey, D. in: PubMed | Google Scholar |

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Forbes Satter, L. in: PubMed | Google Scholar |

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Freeman, A. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Bergerson, J. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Holland, S. in: PubMed | Google Scholar |

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Leiding, J. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Weiss, S. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Hall, M. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Taylor, D. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Feng, R. in: PubMed | Google Scholar |

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Wherry, E. in: PubMed | Google Scholar

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Meyer, N. in: PubMed | Google Scholar |

1Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

2Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, United States of America

3Division of Critical Care Medicine, Department of Anesthesia and Critical C, Children's Hospital of Philadelphia, Philadelphia, United States of America

4Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, United States of America

5Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, United States of America

6Division of Rheumatology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

7Division of Oncology, Department of Pediatrics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

8Division of Immunology, Allergy, and Retrovirology, Department of Pediatric, Texas Children's Hospital and Baylor College of Medicine, Houston, United States of America

9Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, United States of America

10Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Baltimore, United States of America

11Division of Critical Care, Department of Pediatrics, Nemours Children's Health and Sidney Kimmel Medical College at Thomas Jefferson University, Wilmington, United States of America

12Division of Critical Care, Department of Pediatrics, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, United States of America

13Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

14Department of Biostatistics, Center for Clinical Epidemiology and Biostatis, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

15Institute for Immunology and Immune Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

16Institute for Immunology and Immune Health, Children’s Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, United States of America

Find articles by Henrickson, S. in: PubMed | Google Scholar |

Published June 9, 2026 - More info

J Clin Invest. https://doi.org/10.1172/JCI202867.
Copyright © 2026, Lindell et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published June 9, 2026 - Version history
View PDF
Abstract

BACKGROUND. Sepsis is a leading cause of morbidity and mortality in critically ill children, yet heterogeneous immune responses complicate the development of targeted therapies and the host immune factors driving sepsis pathobiology remain unclear.

METHODS. We integrated deep immune phenotyping, plasma proteomics, single-cell transcriptomics, and phosphoflow cytometry in a prospective cohort of 88 critically ill children to elucidate the mechanisms underlying immune heterogeneity.

RESULTS. Unsupervised clustering of plasma cytokines identified three immunologic subgroups, including a high-severity group (“Group C”) characterized by hypercytokinemia driven by IL-6 and IFN-γ. Group C exhibited distinct alterations in immune cell frequency and activation, with a strong association between hyperinflammatory cytokine signaling and lymphocyte dysfunction. Single-cell RNA sequencing revealed transcriptional signatures of T cell activation and metabolic stress, with suppression of a lymphoid protective gene program across CD8⁺ T cell subsets. Despite increased expression of activation markers, T cell receptor repertoire analysis revealed no dominant clonotypes, consistent with bystander activation. Phosphoflow cytometry demonstrated baseline STAT1/STAT3 hyperactivation in Group C CD8⁺ T cells, which failed to respond to αCD3/αCD28/αCD49d stimulation.

CONCLUSIONS. These findings define an IL‑6/IFN‑γ–driven endotype of T cell dysfunction in pediatric sepsis and highlight the JAK/STAT axis as a rational target for immunomodulatory therapy.

FUNDING. K12HD047349, K23GM159013, K08AI135091, R01HD095976, Thrasher Research Foundation, Burroughs Wellcome Fund CAMS, Immune Deficiency Foundation, Primary Immune Deficiency Treatment Consortium, Barbara Brodsky Foundation, CHOP Research Institute

Supplemental material

View Large supplemental tables

View

Version history
  • Version 1 (June 9, 2026): In-Press Preview

Article tools

  • View PDF
  • Download citation information
  • Send a comment
  • Terms of use
  • Standard abbreviations
  • Need help? Email the journal

Metrics

  • Article usage
  • Citations to this article

Go to

  • Top
  • Abstract
  • Supplemental material
  • Version history
Advertisement
Advertisement

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

Sign up for email alerts