[Frontiers in Bioscience 14, 4464-4476, January 1, 2009]

Neutrophils recruitment during sepsis: Critical points and crossroads

Fabiano Pinheiro da Silva, Francisco Garcia Soriano

Emergency Medicine Department, University of Sao Paulo, Brazil

TABLE OF CONTENTS

1. Abstract
2. Introduction
3. The leukocyte-endothelial cell interactions
3.1. Cell adhesion molecules (CAMs)
3.1.1. Selectins
3.1.2. Integrins
3.1.3. Immunoglobulins superfamily
3.2. Neutrophils recruitment dynamics
3.3. Tool-like receptors (TLRs)
3.4. Immunoglobulins Fc receptors (FcRs)
4. Free radical production, poly(ADP-ribose)polymerase activation and organ damage by neutrophils
4.1. Cell Death
4.1.1. Necrosis
4.1.2. Apoptosis
4.2. Proinflammatory Signal
4.3. Circulatory Shock
5. Conclusions

1. ABSTRACT

The mechanisms that initiate an inflammatory systemic response to a bacterial infection lead to a high mortality and constitute the first cause of death in Critical Care Units (ICU's). Sepsis is a poorly understood disease and despite life support techniques and the administration of antibiotics, not much more can be done to improve its diagnosis and treatment. The present article has as main objective to discuss the role of neutrophils recruitment in sepsis, dissecting the molecular mechanisms implicated in this complex process and its importance to the pathogenesis of this outstanding cause of death.