Fig. 2.

Pathological mechanism of sepsis. Under septic conditions, the invasion of immunogens (PAMPs and DAMPs) can over-activate the innate immune system through TLR- and NLR-mediated signaling pathways, causing massive inflammatory cytokine release. These inflammatory cytokines damage the mitochondrial respiratory chain, triggering RONS overproduction. Importantly, because RONS can induce cell apoptosis and reactivate PRR signaling pathways by inducing DAMP formation, it creates a vicious cycle between inflammation and RONS. Thus, inflammation and RONS are the two core factors in the pathological mechanism of sepsis.