• Open Access

The Immunopathology of Sepsis: Pathogen Recognition, Systemic Inflammation, the Compensatory Anti-Inflammatory Response, and Regulatory T Cells

Authors

  • D.H. Lewis,

    1. Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hatfield Campus, Hertfordshire,, UK (Lewis, Chan, Garden)
    Current affiliation:
    1. Langford Veterinary Services, Small Animal Hospital, Langford, Bristol, BS40 5DU, UK
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  • D.L. Chan,

    1. Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hatfield Campus, Hertfordshire,, UK (Lewis, Chan, Garden)
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  • D. Pinheiro,

    1. Regulatory T Cell Laboratory, The Royal Veterinary College, Camden Campus, London, NW1 OTU, UK (Pinheiro, Garden)
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  • E. Armitage-Chan,

    1. Davies Veterinary Specialists, Manor Farm Business Park, Hertfordshire, SG5 3HR, UK (Armitage-Chan)
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  • O.A. Garden

    Corresponding author
    1. Regulatory T Cell Laboratory, The Royal Veterinary College, Camden Campus, London, NW1 OTU, UK (Pinheiro, Garden)
    • Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hatfield Campus, Hertfordshire,, UK (Lewis, Chan, Garden)
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Corresponding author: O.A. Garden, Department of Veterinary Clinical Sciences, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, UK; e-mail: ogarden@rvc.ac.uk.

Abstract

Sepsis, the systemic inflammatory response to infection, represents the major cause of death in critically ill veterinary patients. Whereas important advances in our understanding of the pathophysiology of this syndrome have been made, much remains to be elucidated. There is general agreement on the key interaction between pathogen-associated molecular patterns and cells of the innate immune system, and the amplification of the host response generated by pro-inflammatory cytokines. More recently, the concept of immunoparalysis in sepsis has also been advanced, together with an increasing recognition of the interplay between regulatory T cells and the innate immune response. However, the heterogeneous nature of this syndrome and the difficulty of modeling it in vitro or in vivo has both frustrated the advancement of new therapies and emphasized the continuing importance of patient-based clinical research in this area of human and veterinary medicine.

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