Nucleotide-binding oligomerization domain (NOD) protein 1 (NOD1) and NOD2 are pathogen recognition receptors that sense breakdown products of peptidoglycan (PGN) (muropeptides). It is shown that a number of these muropeptides can induce tumor necrosis factor alpha (TNF-␣) gene expression without significant TNF-␣ translation. This translation block is lifted when the muropeptides are coincubated with lipopolysaccharide (LPS), thereby accounting for an apparently synergistic effect of the muropeptides with LPS on TNF-␣ protein production. The compounds that induced synergistic effects were also able to activate NF-B in a NOD1-or NOD2-dependent manner, implicating these proteins in synergistic TNF-␣ secretion. It was found that a diaminopimelic acid (DAP)-containing muramyl tetrapeptide could activate NF-B in a NOD1-dependent manner, demonstrating that an exposed DAP is not essential for NOD1 sensing. The activity was lost when the ␣-carboxylic acid of iso-glutamic acid was modified as an amide. However, agonists of NOD2, such as muramyl dipeptide and lysine-containing muramyl tripeptides, were not affected by amidation of the ␣-carboxylic acid of iso-glutamic acid. Many pathogens modify the ␣-carboxylic acid of iso-glutamic acid of PGN, and thus it appears this is a strategy to avoid recognition by the host innate immune system. This type of immune evasion is in particular relevant for NOD1.The ability to rapidly recognize microbial components and respond by initiating an acute inflammatory response is a crucial first line of defense against a microbial challenge. Overactivation of this inflammatory response can, however, lead to the clinical symptoms of septic shock and results in 100,000 deaths annually in the United States (33, 34). It has been estimated that 1% of hospitalized patients and 20 to 30% of patients in intensive care units develop sepsis. The advent of new antimicrobial resistance patterns, the increasing use of chemotherapeutic agents, and the emergence of diseases characterized by immunosuppression have caused the incidence of septic shock to increase dramatically.Lipopolysaccharide (LPS), peptidoglycan (PGN), and lipoteichoic acid are three principal bacterial cell wall components implicated in inducing the clinical manifestations of septic shock (47). These components exert their biological effects by stimulating the host's monocytes and macrophages to produce proinflammatory mediators, such as tumor necrosis factor alpha (TNF-␣), interleukin-1 (IL-1), and IL-6. These mediators in turn elicit a variety of inflammatory responses in the host.LPS, a vital component of the outer leaflet of the gramnegative bacterial outer membrane, comprises three structural units: an outer polysaccharide component, a core oligosaccharide region, and the innermost portion, lipid A (5, 32). The lipid A region is largely responsible for the proinflammatory activity of LPS and generally consists of a hexa-acylated bis-1,4Ј-phosphorylated glucosamine disaccharide. The results of recent studies indicate that the lipid ...