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Published on: February 20, 2021
Pro-inflammatory mechanisms in sepsis
Abstract:
Sepsis is characterised by a hyper-inflammatory response due to microbial infection. We here review our current understanding of host mechanisms employed to mediate this hyper-inflammatory response, drawing together current knowledge pertaining to pathogen recognition and host pro-inflammatory response. Recognition of microbial derived ligands by pattern recognition receptors (PRRs) is a key step in initiating pro-inflammatory signalling pathways. Examples of PRRs linked to the aetiology of sepsis include Toll-like, C-type lectin, RIG-1-like and also Nod-like receptors, which are involved in the formation of the inflammasome, crucial for the maturation of some pro-inflammatory cytokines. Bacterial superantigens have evolved to exploit host MHC class II and T cell receptors (normally considered part of the adaptive immune response) as innate PRRs to propagate a so-called 'cytokine storm', while synergy between different microbial ligands and host-derived alarmins can augment the inflammatory response still further through as yet poorly understood interactions. The host pro-inflammatory response results in the characteristic features of inflammation: rubor, calor, dolor, and tumor. We will review herein the key mediators of inflammation in sepsis, identifying their overlapping and intersecting roles in vascular changes in tone, endothelial permeability, coagulation and contact activation, leukocyte mobilisation and activation.
Insights
Sepsis involves a severe inflammatory response to infection. This review details how the body recognizes pathogens via pattern recognition receptors (PRRs) and triggers inflammation, leading to a
Area of Science:
- Immunology
- Pathology
- Microbiology
Background:
- Sepsis is a life-threatening condition characterized by a dysregulated hyper-inflammatory host response to microbial infection.
- Pathogen recognition by host immune cells is a critical initial step in initiating the inflammatory cascade.
- Understanding these host mechanisms is crucial for developing effective sepsis treatments.
Purpose of the Study:
- To review current knowledge on host mechanisms mediating the hyper-inflammatory response in sepsis.
- To synthesize information on pathogen recognition pathways and subsequent pro-inflammatory signaling.
- To elucidate the roles of various mediators in sepsis-induced inflammation.
Main Methods:
- Literature review of current research on sepsis pathogenesis.
- Analysis of host pattern recognition receptors (PRRs) and their signaling pathways.
- Examination of inflammatory mediators and their involvement in vascular and cellular responses.
Main Results:
- Pattern recognition receptors (PRRs), including Toll-like, C-type lectin, RIG-1-like, and Nod-like receptors, are key in initiating sepsis inflammation.
- Nod-like receptors are involved in inflammasome formation, crucial for pro-inflammatory cytokine maturation.
- Bacterial superantigens exploit host receptors to induce a 'cytokine storm', amplifying the inflammatory response.
Conclusions:
- Host recognition of microbial ligands via PRRs is central to sepsis-induced inflammation.
- The inflammatory response involves complex interactions between microbial products, host receptors, and alarmins.
- Key mediators orchestrate vascular changes, endothelial permeability, coagulation, and leukocyte activation in sepsis.
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