Role of flagellin in the pathogenesis of shock and acute respiratory distress syndrome: Therapeutic opportunities

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Abstract
To provide an overview of the role of flagellin as an immunostimulatory and proinflammatory factor. A systematic overview of the literature on this subject. An office equipped with a computer and Internet access to PubMed. MEDLINE citations between 1960 and 2002. 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. 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.