Toll-like receptor 9 inhibition reduces mortality in polymicrobial sepsis

J Exp Med. 2008 Jun 9;205(6):1277-83. doi: 10.1084/jem.20080162. Epub 2008 May 12.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adoptive Transfer
  • Animals
  • Bacterial Infections / immunology
  • Bacterial Infections / physiopathology*
  • Cytokines / physiology
  • Dendritic Cells / immunology
  • Granulocytes / physiology
  • Inflammation / prevention & control*
  • Leukocyte Count
  • Lymphocytes / physiology
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Sepsis / immunology
  • Sepsis / physiopathology*
  • Survivors
  • Toll-Like Receptor 9 / deficiency*

Substances

  • Cytokines
  • Tlr9 protein, mouse
  • Toll-Like Receptor 9