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Erschienen in: Critical Care 5/2006

01.10.2006 | Review

Bench-to-bedside review: Endotoxin tolerance as a model of leukocyte reprogramming in sepsis

verfasst von: Jean-Marc Cavaillon, Minou Adib-Conquy

Erschienen in: Critical Care | Ausgabe 5/2006

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Abstract

Endotoxin tolerance is defined as a reduced responsiveness to a lipopolysaccharide (LPS) challenge following a first encounter with endotoxin. Endotoxin tolerance protects against a lethal challenge of LPS and prevents infection and ischemia-reperfusion damage. Endotoxin tolerance is paralleled by a dramatic reduction of tumor necrosis factor (TNF) production and some other cytokines in response to LPS. Endotoxin tolerance involves the participation of macrophages and mediators, such as glucocorticoids, prostaglandins, IL-10, and transforming growth factor-β. Endotoxin tolerance is accompanied by the up-regulation of inhibitory molecules that down-regulate the Toll-like receptor (TLR)4-dependent signaling pathway. Cross-tolerance between LPS and other TLR specific ligands, as well as IL-1 and TNF, has been regularly reported. A similar loss of LPS reactivity has been repeatedly reported in circulating leukocytes of septic patients and in patients with non-infectious systemic inflammation response syndrome (SIRS). Studies on cellular signaling within leukocytes from septic and SIRS patients reveal numerous alterations reminiscent of those observed in endotoxin tolerant cells. However, altered responsiveness to LPS of leukocytes from sepsis and SIRS patients is not synonymous with a global down-regulation of cellular reactivity. The term 'cellular reprogramming', which has been proposed to qualify the process of endotoxin tolerance, defines well the immune status of circulating leukocytes in septic and SIRS patients.
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Metadaten
Titel
Bench-to-bedside review: Endotoxin tolerance as a model of leukocyte reprogramming in sepsis
verfasst von
Jean-Marc Cavaillon
Minou Adib-Conquy
Publikationsdatum
01.10.2006
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 5/2006
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc5055

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