Sepsis is defined as the body's overwhelming and life-threatening response to
infection that can lead to tissue damage, organ failure, and death. Since
bacterial infection is one of the main causes of
sepsis, appropriate antimicrobial
therapy remains the cornerstone of
sepsis and
septic shock management. However, since
sepsis is a multifaceted chaos involving
inflammation and anti-
inflammation disbalance leading to the unregulated widespread release of inflammatory mediators,
cytokines, and pathogen-related molecules leading to system-wide organ dysfunction, the whole body control to prevent the progression of organ dysfunction is needed. In
sepsis and
septic shock,
pathogen-associated molecular patterns (
PAMPs), such as bacterial
exotoxins, cause direct cellular damage and/or trigger an immune response in the host.
PAMPs are recognized by pattern recognizing receptors (
PRRs) expressed on immune-reactive cells.
PRRs are also activated by host nuclear, mitochondrial, and cytosolic
proteins, known as damage-associated molecular patterns (DAMPs) that are released from cells during
sepsis. Thus, most
PRRs respond to
PAMPs or DAMPs by triggering activation of transcriptional factors, NF-κB, AP1, and STAT-3. On the other hand,
sepsis leads to immune (lymphocytes and macrophages) and nonimmune (endothelial and epithelial cells) cell death. Apoptosis has been the major focus of research on cell death in
sepsis, but autophagy,
necrosis, necroptosis, pyroptosis, NETosis, and ferroptosis may also play an important role in this critical situation. The recent development in our understanding regarding the cellular pathogenesis of
sepsis will help in developing new treatment of
sepsis.