Sepsis still remains one of the leading causes of death in critical care units all over the world. It seems that one of the major pathophysiological events in sepsis is the extreme activation of the immune system, which leads to massive production of several cytokines and other mediators of inflammation. Pattern Recognition Receptors (PRRs) are responsible for the recognition of the pathogens by the innate immunity cells and for the consequent cytokine production. This fact shows that PRRs could possibly play an important role in sepsis pathogenesis. Among all PRRs, TLR4 (Toll Like Receptor 4) and CD14 are primarily responsible for the recognition of Gram(-) bacteria, which are responsible for the majority of sepsis cases. It seems that the expression of TLR4 and CD14 present alterations during sepsis. Some of these alterations could be used as prognostic factors in septic patients, as they have been correlated with better or worse outcome. Finally, TLR4 and CD14 represent possible targets in sepsis treatment. Many attempts have been done to block these two receptors at many levels, using monoclonal antibodies, soluble analogues and especially antagonists. Results, in some cases encouraging in others disappointing, are still being tested
