Role of flagellin in the pathogenesis of shock and acute respiratory distress syndrome: therapeutic opportunities.
OBJECTIVE
To provide an overview of the role of flagellin as an immunostimulatory and proinflammatory factor.


METHODS
A systematic overview of the literature on this subject.


METHODS
An office equipped with a computer and Internet access to PubMed.


METHODS
MEDLINE citations between 1960 and 2002.


RESULTS
Flagellin, a protein of 40-60 kD, is the principal constituent of the flagellum, a prominent surface structure found in motile bacteria. Recent work reveals that monomeric flagellin, a protein component of flagellated bacteria, can act as a soluble immunostimulatory and proinflammatory factor, activating the immune/inflammatory axis via the toll-like receptor 5-nuclear factor-kappaB axis. Monocytes, macrophages, and intestinal and pulmonary epithelial cells respond to monomeric flagellin at low concentrations. Monomeric flagellin can induce prominent local and systemic immune/inflammatory responses and.


CONCLUSIONS
Recognition of the flagellin-toll-like receptor 5 pathway offers novel opportunities for the experimental therapy of various forms of shock, sepsis, and acute respiratory distress syndrome.
Szabó
Csaba
C
Inotek Pharmaceuticals Corporation, Beverly, MA, USA.
D000208:Acute Disease; D000276:Adjuvants, Immunologic / Q000494:pharmacology* / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000502:physiology* / Q000627:therapeutic use; D005408:Flagellin / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007107:Immune System / Q000187:drug effects* / Q000503:physiopathology*; D007249:Inflammation / Q000188:drug therapy / Q000503:physiopathology; D012128:Respiratory Distress Syndrome / Q000188:drug therapy / Q000503:physiopathology*; D012769:Shock / Q000188:drug therapy / Q000503:physiopathology*
D000276:Adjuvants, Immunologic; D001426:Bacterial Proteins; D005408:Flagellin