Figure 5.

Proposed schematic mechanism of modulation of cell death. TLR4 signaling may modulate cell apoptosis related to the Bcl2 to Bax ratio in patients with sepsis. TLR4 inhibition using anti-TLR4 antibody might lead to an increase in Bcl2 to Bax ratio, which decreases Cyto C release from mitochondria. Activities of caspase-3, caspase-8, and caspase-9 did not change. Enhanced stimulation of RAGE might elevate pyroptosis, which increased cell death totally (TLR = toll-like receptor; Bcl2 = B cell lymphoma 2; Bax = Bcl2-associated X; Cyto C = cytochrome C; RAGE = receptor for advanced glycation end products; LPS = lipopolysaccharide; HMGB1 = high-mobility group box 1; TNF = tumor necrosis factor; TNFR = TNF receptor; ROS = reactive oxygen species; NF-κB = nuclear factor kappa-light-chain-enhancer of activated B cells).