A new systems approach to diseased states and wellness result in a new branch in the healthcare services, namely, personalized and precision medicine (PPM). The latter is a radically new trend which utilizes each patient’s individual genomic landscapes to create a biomarker-based targeted therapy and rehabilitative protocol.To achieve the implementation of PPM concept into the daily clinical and post-operative rehabilitation-related practice, it is necessary to create a fundamentally new strategy making precision surgery (PS) and PS-associated personalized rehabilitation (PR) (PS-PR) as a new approach to health care that customizing patients’ medical treatment according to their own genetic information. This new combinatorial and evidence-based approach is the result of increased knowledge of the human genome and phenome and ways this information can be applied by surgeons and physicians in the medical and surgical management of their patients. In this sense, a patient’s genotype can yield important information concerning disease systems-related susceptibility and the effectiveness of medications, therefore guiding specific, targeted imaging, treatment and rehabilitative therapies.In this sense, identifying drug-response phenotypes by examining interactions between phenotypes and sepsis therapies is a priority to optimize clinical trials. Adaptive trials (response-adaptive randomization) should be performed if endophenotypes are not available or when multiple endophenotypes (identified by measuring OMICS markers) are present. Use of electronic health records should be explored to identify such endophenotypes, whose replication in multiple datasets require big data with harmonization across multiple sites to determine the robustness of such endophenotypes for sepsis prognosis.The remarkable progress in the field of sepsis and its complications can be attributed to the latest advances in OMIC-technologies and sepsis modeling, together with a better understanding of the immunopathology, biology and epidemiology of sepsis syndrome. Experimental models of sepsis can provide a clear understanding the pathophysiology of sepsis and confirm its evolution to septic shock. The focus of the biodesign-driven translational research and applications is nowadays on the interplay between therapies, pathogens, and the host. Regarding the pathogen-inducer, microbiologic diagnostic approaches are discussed, as well as multi-targeted (combinatorial) treatment, since sepsis is certainly the sum of multiple host-microbial interactions.Other topics include the disruption of host immune system and the use of specific biomarkers in sepsis management and patient stratification. Previous attempts at reducing mortality with multi-cytokine mediation have failed to reduce mortality across all patient parameterizations and motivated us to investigate whether adaptive, personalized multi-cytokine mediation can control the trajectory of sepsis and lower patient mortality. But the other approaches focusing on adaptive and personalized multi-cytokine mediation therapy, could be a promising future for treating sepsis.Among the latest innovations in the field, for instance, ImmunoSep, illustrating the advanced innovations in personalized immunotherapy and developing a next-generation theranostics platform for the personalized targeted immunotherapy, aims at significantly improving the treatment outcome of sepsis in individual patients.Finally, PPM in sepsis entails making an early and accurate microbiologic diagnosis, determining the host immune response signature and assessing individual response to treatment, in order to tailor therapy to the specific needs of each individual patient. So, sepsis requires the physician to accurately place the patient in the appropriate cohort that is relevant to the test being used and that is designed for the individual patient, or at least for a homogeneous group of patients who share specific characteristics. In this sense, PPM and its unique resources are likely to be harder to use in sepsis than in some other clinical settings. We are offering a new view on the management of PPM in sepsis-related precision surgery associated with personalized rehabilitation which, to our mind, strongly stresses the need to discuss the management of PS-PR on an individual basis in an interdisciplinary context, in order to offer the best possible surgical, therapeutic and rehabilitative approach. In this sense, the infrastructure of the Center for Precision Surgery & Personalized Rehabilitation (CPSPR) should have, at least, four essential components: 1) genomic/molecular data acquisition and storage, 2) integration of genomic diagnostic testing and targeted imaging, 3) research focused on functional genomic targets, and 4) development and informed use of targeted therapies of actionable genes. Moving forward, clear and centralized consensus on actionable genes is needed.

Sergey Suchkov was born in the City of Astrakhan, Russia, in a family of dynasty medical doctors. In 1980, graduated from Astrakhan State Medical University and was awarded with MD. In 1985, Suchkov maintained his PhD as a PhD student of the I.M. Sechenov Moscow Medical Academy and Institute of Medical Enzymology. In 2001, Suchkov maintained his Doctor Degree at the National Institute of Immunology, Russia.

From 1989 through 1995, Dr Suchkov was being a Head of the Lab of Clinical Immunology, Helmholtz Eye Research Institute in Moscow. From 1995 through 2004 - a Chair of the Dept for Clinical Immunology, Moscow Clinical Research Institute (MONIKI). In 1993-1996, Dr Suchkov was a Secretary-in-Chief of the Editorial Board, Biomedical Science, an international journal published jointly by the USSR Academy of Sciences and the Royal Society of Chemistry, UK.