Toll-like receptor 4 in sepsis: where do we stand?

Severe sepsis and septic shock remain a leading cause of death with mortality rate ranging between 35% and 60% in critically ill patients, despite aggressive antibiotic therapy and vigorous supportive treatment [1, 2]. Although some experimental approaches appeared to be successful in controlling the development of septic syndrome, only limited benefit was shown in large clinical trials [3–8]. Thus, a better understanding of the molecular mechanisms of the host immune response to microbes is fundamental to define the pathophysiology of sepsis and to guide novel therapeutic strategies.