PIM3 and septic shock: Moreover, excessive neutrophils can suppress adaptive immunity by inhibiting T cell activation and proliferation.[30] CD8+ T cells are essential for pathogen clearance, and their depletion may impair cytotoxic responses, increasing the risk of secondary infections in the later stages of sepsis.[31,32] Further analysis showed that high expression of SIGLEC5, PIM3, CHIT1, and NEDD4 was significantly negatively correlated with CD8+ T cell infiltration, indicating their potential role in promoting immunosuppression in pediatric septic shock.