Diagnostic significance of Toll-like receptors 4 in critical patients with infectious complications of the respiratory organs

Abstract

n. Ventilator-associated respiratory infection (VARI) is a common hospital complication in the intensive care unit (ICU) associated with medical care [1]. Among which there are known ventilator-associated tracheobronchitis and ventilator-associated pneumonia (VAP), occuring in approximately 20% of patients who are on mechanical ventilation for more than 48 hours and the mortality rate is about 30% [2, 3]. Methods and criteria for the diagnosis of VAP are still controversial [4]. Investigation of new attempts for its quick diagnostics are of great importance for timely individual correction etiotropic antibiotic treatment. In recent years, attempts have been made to identify biological markers of infection manifestation [6, 7] Toll-like receptors (TLRs) recognize pathogenic microorganisms and generate an immediate protective response by inducing the production of pro-inflammatory cytokines [8]. TLRs of type 4 (TLR-4), which are expressed in different types of immune system cells, are associated with different states of cellular activation, immune protection, homeostasis, and various diseases, specifically recognize bacterial lipopolysaccharide, leading to the synthesis of pro-inflammatory cytokines and chemokines [9, 10,11]. Nowadays it is widely studied for diagnostic and therapeutic purposes in infectious complications