Toll-like receptor 9 inhibition reduces mortality in polymicrobial sepsis

G Plitas, BM Burt, HM Nguyen, ZM Bamboat… - The Journal of …, 2008 - rupress.org
G Plitas, BM Burt, HM Nguyen, ZM Bamboat, RP DeMatteo
The Journal of experimental medicine, 2008rupress.org
The high rate of mortality in patients with sepsis results from an inappropriately amplified
systemic inflammatory response to infection. Toll-like receptors (TLRs) are important for the
activation of innate immunity against microbial pathogens. We demonstrate a critical role of
TLR9 in the dysregulated immune response and death associated with sepsis. Compared
with wild-type (WT) mice, TLR9−/− mice exhibited lower serum inflammatory cytokine levels,
higher bacterial clearance, and greater survival after experimental peritonitis induced by …
The high rate of mortality in patients with sepsis results from an inappropriately amplified systemic inflammatory response to infection. Toll-like receptors (TLRs) are important for the activation of innate immunity against microbial pathogens. We demonstrate a critical role of TLR9 in the dysregulated immune response and death associated with sepsis. Compared with wild-type (WT) mice, TLR9−/− mice exhibited lower serum inflammatory cytokine levels, higher bacterial clearance, and greater survival after experimental peritonitis induced by cecal ligation and puncture (CLP). Protection of TLR9−/− mice after CLP was associated with a greater number of peritoneal dendritic cells (DCs) and granulocytes than in WT controls. Adoptive transfer of TLR9−/− DCs was sufficient to protect WT mice from CLP and increased the influx of peritoneal granulocytes. Subsequent experiments with a depleting antibody revealed that granulocytes were required for survival in TLR9−/− mice. Remarkably, a single injection of an inhibitory CpG sequence that blocks TLR9 protected WT mice, even when administered as late as 12 h after CLP. Our findings demonstrate that the detrimental immune response to bacterial sepsis occurs via TLR9 stimulation. TLR9 blockade is a potential strategy for the treatment of human sepsis.
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