Editorial: Biomarker-driven strategies for personalized management of systemic inflammatory response syndrome

The contributions follow two main goals: SIRS pathobiology and biomarker-AI integrated models. A group of these articles focuses on pathobiology via multi-omics signatures, mapping how immune activation leads to organ resolution across different etiologies and ages. The other focus is the 'howto' of implementing biomarkers through artificial intelligence (AI) integration, targeted interventions, and governance models to ensure these tools are deployed equitably, especially in pediatric emergencies, and address implementation barriers. Ultimately, scientific advancement must be paired with ethical responsibility. Stolte et al. explore this through expert interviews, focusing on the unique challenges of implementing OMICS and AI-driven therapies in pediatric SIRS. Their findings call for adaptive consent processes using visual tools for child empowerment, alongside pragmatic emergency protocols and interdisciplinary guidelines that move beyond simple precautionary restrictions. Experts further emphasize data stewardship, equity safeguards against multi-omics biases, and the need for specialized training to ensure trustworthy AI systems during clinical crises.Together, these 11 articles provide a comprehensive roadmap for personalizing SIRS care, bridging the gap between accessible diagnostics, like saliva tests and simple blood indices, and the complex ethical frameworks required for their use. By highlighting the risks of data bias and clinical inequality, these contributors call for a shift toward globally coordinated trials. The goal is clear: to move away from empirical, 'blind' treatments in favour of biomarker-guided strategies that prioritize both clinical efficacy and social equity.Collectively, these contributions move beyond isolated markers by integrating diverse tools, from noninvasive saliva proxies to high-fidelity animal models, into cohesive clinical platforms. Ultimately, this collection serves as a catalyst, guiding SIRS management toward a more accountable and truly patientcentered future.