Application of Epigenetic biomarkers in the precision medicine for sepsis-induced acute lung injury: From risk stratification to targeted therapy

Sepsis-induced acute lung injury (SI-ALI) remains a leading cause of mortality in critical care, characterized by complex pathophysiology and substantial patient heterogeneity that challenge conventional diagnostic and therapeutic approaches. Precision medicine, which tailors prevention, diagnosis, and treatment strategies to individual patient characteristics, offers a promising avenue to improve outcomes in this condition. This review focuses on the pivotal role of epigenetic modifications—including DNA methylation, histone modifications, and non-coding RNAs—in the pathogenesis and progression of SI-ALI. We comprehensively summarize recent advances in understanding how these epigenetic mechanisms contribute to disease heterogeneity and influence clinical trajectories. Furthermore, we highlight the emerging potential of epigenetic biomarkers as tools for risk stratification, prognostic evaluation, and guidance of targeted therapeutic interventions in SI-ALI. By integrating current research findings, this article aims to establish a novel theoretical framework and translational direction for the precision management of SI-ALI, ultimately facilitating the development of personalized treatment strategies to address the unmet clinical needs in this critical condition.