TLRs genetic expression: a tool to predict and diagnose sepsis before its clinical evidence?

摘要

To the Editor: I have read with great interest the article "Differential expression of TLR genes: sepsis compared with sterile inflammation 1 day before sepsis diagnosis" by Lissauer et al. (1), which was recently published on this journal. Sepsis is a complex clinical syndrome that results from the host's inability to regulate the inflammatory response against infection and that is often not distinguishable from SIRS in its initial phases, and-sometimes-until a documented microbial isolation is obtained. Lissauer et al. (1) demonstrated a significant difference in TLR genes activation 1 day before sepsis was clinically evident, allowing the physician to distinguish SIRS (sterile) from sepsis patients (infected). These data are very important because predicting the development of a sepsis before its clinical and laboratory signs are evident could save thousands of lives by starting appropriate antibiotic therapy timely. Another very stimulating topic, which is not emergent from discussion in the article of Lissauer et al. (1), is if the extent of genetic expression of TLRs (twofolds, threefolds, etc.) was associated with a better or worse recovery from sepsis.