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Sepsis Syndrome: Bacterial Endotoxin

Source: www.oup.com
Topic: Sepsis
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Sort Desciption: Sepsis syndrome is a systemic response to invasive pathogens Sepsis syndrome, or sepsis, is an adverse systemic response to infection that includes fever, rapid heartbeat and respiration, low blood pressure and organ dysfunction associated with compromised circulation. ...

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Sepsis Syndrome: Bacterial Endotoxin Sepsis syndrome is a systemic response to invasive pathogens Sepsis syndrome, or sepsis, is an adverse systemic response to infection that includes fever, rapid heartbeat and respiration, low blood pressure and organ dysfunction associated with compromised circulation. Approximately 250,000750,000 cases of sepsis occur annually in the United States of America, with mortality ranging from 20% to 50% overall and as high as 90% when shock develops. Sepsis can occur through infection with Gram-positive bacteria and even fungi and viruses, or as a consequence of secreted toxins, which we discuss in the next section. However, the sepsis syndrome occurs commonly in response to lipopolysaccharide (LPS) from Gram-negative bacteria, which will be illustrated here. Lipopolysaccharide recognition occurs via the innate immune system LPS is a major constituent of Gram-negative bacterial cell walls (see section 3-0) and is essential for membrane integrity. The portion of LPS that causes shock is the innermost and most highly conserved phosphoglycolipid, lipid A (Figure 9-6), which acts by potently inducing inflammatory responses that are life-threatening when systemic (see below), and is known as bacterial endotoxin. Multicellular organisms from horseshoe crabs and fruit flies to humans have evolved proteins specialized for the recognition of LPS. These proteins are found both on the surface of phagocytic cells and as soluble proteins in blood. LPS is removed by macrophages through scavenger receptors (for example, SR-A) that are highly expressed in the liver and are thus positioned to remove LPS from portal blood draining the intestines, and by neutrophils through the primary granule protein, bactericidal permeabilityincreasing protein (BPI), which is toxic to Gram-negative bacteria (see section 3-9). The homologous LPS-binding protein, LBP, transfers LPS to membrane-bound or soluble CD14, enabling interactions with Toll-like receptors (TLRs) ...

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