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Severe sepsis and Toll-like receptors

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Abstract

Severe sepsis dominates the mortality of non-cardiac intensive care units. The ingenious Toll-like receptor (TLR) system can recognise many infectious organisms through relatively few receptors to trigger pro-inflammatory and anti-inflammatory cytokine release. Further complexity arises from positive and negative signalling feedback loops. Severe sepsis may be a consequence of an inappropriately excessive response or inadequate endogenous negative feedback. Therapies targeting these pathways are currently being evaluated. Alternatively, in clinical scenarios such as compensatory anti-inflammatory response syndrome, chronic viral sepsis or inadequate vaccine function, TLR signalling may be inadequate. TLR agonists may augment the innate response and are being investigated.

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Authors and Affiliations

  1. Unit of Critical Care Medicine, National Heart and Lung Institute, Imperial College, London, SW3 6LY, UK

    Hongmei Gao, Susannah K. Leaver, Anne Burke-Gaffney & Simon J. Finney

  2. Adult Intensive Care Unit, Royal Brompton Hospital, Sydney Street, London, SW3 6LY, UK

    Simon J. Finney

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  1. Hongmei Gao
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  2. Susannah K. Leaver
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Gao, H., Leaver, S.K., Burke-Gaffney, A. et al. Severe sepsis and Toll-like receptors. Semin Immunopathol 30, 29–40 (2008). https://doi.org/10.1007/s00281-007-0101-4

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