Collectively, our in vitro system of repetitive LPS challenges for a 5-day time period generated a representative monocyte exhaustion phenotype with reduced expression of MHCII and co-stimulatory molecule CD86, as well as continued induction of immuno-suppressor PD-L1, consistent with the exhausted monocyte phenotype observed in experimental animals and human sepsis patients (29–31). The gene discussed is CD274; the disease is Sepsis.