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Mol Med Today. 1999 Mar;5(3):123-32.

The molecular pathogenesis of endotoxic shock and organ failure.

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Dept of Molecular Preventive Medicine, Faculty of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyou-ku, Tokyo, 113-0033, Japan.


Sepsis is still associated with a high mortality rate. Septic shock and sequential multiple organ failure have a strong correlation with poor outcome. Lipopolysaccharide (LPS) plays a pivotal role in the initiation of host responses to Gram-negative infection. A number of mediators, such as cytokines, nitric oxide and eicosanoids, are responsible for most of the manifestations caused by LPS, and circulatory failure, leukocyte-induced tissue injury and coagulation disorder appear to be critical determinants in the development of sequential organ failure. Although several anti-LPS or anti-cytokine clinical trials have been attempted, none of them has so far been successful.

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