Modulating toll-like receptor signalling as a novel antiinfective approach

The innate immune response against invading microorganisms results in the deployment of phagocytes, including macrophages and dendritic cells to recognize pathogen-associated molecular patterns. Activation of Toll-like receptors (TLRs) expressed on these cells is a critical step in the initiation of this response, triggering the production of pro- and antiinflammatory cytokines to dampen microbial pathogenesis. Importantly, TLR activation also mediates dendritic cell maturation, a critical step in bridging the innate and adaptive arms of the immune system. Balancing the role of TLRs as central mediators of overlapping signaling pathways, whether directly through ligand interactions or via secondary adaptor molecules, mandates exquisite specificity. Further, understanding the immunopharmacology of TLR cross-talk during infection may help to provide insight into innate immunity and the mechanisms of immune-response subversion by pathogens. The continual and rapid emergence of drug resistance to traditional antimicrobial agents highlights the medical need for new treatment approaches. Herein, the discovery and development of TLR agonist and antagonist therapies for infectious diseases as adjunct to, or in place of, conventional treatment paradigms is discussed.