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01-10-2006 | Review

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

Authors: Jean-Marc Cavaillon, Minou Adib-Conquy

Published in: Critical Care | Issue 5/2006

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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Title: Bench-to-bedside review: Endotoxin tolerance as a model of leukocyte reprogramming in sepsis
Authors: Jean-Marc Cavaillon
Minou Adib-Conquy
Publication date: 01-10-2006
Publisher: BioMed Central
Published in: Critical Care / Issue 5/2006
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc5055

At a glance: The STEP trials

Springer Medicine

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

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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Follow-up of newborns treated with extracorporeal membrane oxygenation: a nationwide evaluation at 5 years of age

Second International Conference on Rapid Response System and Medical Emergency Team, 28–30 June 2006, Pittsburgh, PA, USA

Social support during intensive care unit stay might improve mental impairment and consequently health-related quality of life in survivors of severe acute respiratory distress syndrome