The molecular pathogenesis of endotoxic shock and organ failure

Mol Med Today. 1999 Mar;5(3):123-32. doi: 10.1016/s1357-4310(98)01430-0.


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.

Publication types

  • Review

MeSH terms

  • Gram-Negative Bacterial Infections / physiopathology
  • Humans
  • Inflammation Mediators / immunology
  • Inflammation Mediators / metabolism
  • Lipopolysaccharides / immunology
  • Lipopolysaccharides / metabolism
  • Multiple Organ Failure / genetics*
  • Multiple Organ Failure / physiopathology*
  • Multiple Organ Failure / therapy
  • Shock, Septic / genetics*
  • Shock, Septic / physiopathology*
  • Shock, Septic / therapy
  • Signal Transduction


  • Inflammation Mediators
  • Lipopolysaccharides