Role of translocation of pathogen-associated molecular patterns in sepsis.

BACKGROUND/AIM Unlike animals, the incidence of bacterial translocation and its clinical significance remain to be determined in humans, which may be due to the lack of accurate methods to confirm and monitor bacterial translocation. The literature on the consequences of novel insights of bacterial translocation was reviewed. METHODS The Medline databases were searched for publications regarding translocation of bacteria as well as pathogen-associated molecular patterns. RESULTS Although substantial data support the occurrence of bacterial translocation in humans, the lack of data correlating bacterial translocation with its clinical significance has lead to confusion among physicians. Toll-like receptors have been implicated in the mediation of systemic responses to the relevant pathogen-associated molecular pattern. The gut is a reservoir of pathogen-associated molecular patterns from microbes, and translocation of pathogen-associated molecular patterns other than endotoxin also induces a systemic inflammatory response through toll-like receptors. CONCLUSIONS Pathogen-associated molecular patterns translocation may be at least partly responsible for the development of sepsis under conditions in which bacterial translocation may occur. Detection of bacterial DNA in blood and tissues/organs should be useful as a marker of translocation of pathogen-associated molecular patterns and/or bacterial translocation, and should have the predictive value for developing sepsis in surgical patients.