Sepsis since the discovery of Toll-like receptors: Disease concepts and therapeutic opportunities

Authors:
  • SFSimon J. Finney
    Simon J. Finney
  • ABAnne Burke-Gaffney
    Anne Burke-Gaffney
  • TETimothy W. Evans
    Timothy W. Evans
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Abstract
Sepsis and its sequelae are the leading cause of death in critically ill patients. Discovery in the late 1990s of Toll-like receptors as primary sensors of microbial infection led to significant advances in understanding the pathogenesis of sepsis, including emerging differences between Gram-positive and Gram-negative infection and the potential for the manipulation of Toll-like receptors for the treatment of sepsis. This review describes these advances. Bibliographic search of the literature since 1999, with particular emphasis on the conceptual and therapeutic implications of Toll-like receptors for patients with systemic sepsis. Toll-like receptors initiate the inflammatory processes that underlie the clinical response to infection and therefore represent an important putative target for therapeutic intervention.

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