“…LPS-tolerized macrophages, which are re-challenged by LPS after prior exposure to LPS, are regarded as the common model of hypo-responsiveness for SAIS (13)(14)(15). The studies showed that endotoxin tolerance reprograms TLR4 signaling with decreased proinflammatory cytokine production but increased anti-proinflammatory cytokine production by decreasing TLR4 expression, blocking tyrosine phosphorylation of TLR4 and TIRAP, TLR4-MyD88, and IRAK1-MyD88 assemblies, attenuating activation of IRAK4 and IRAK1, inhibiting K63-linked ubiquitination of IRAK1 and TRAF6, or increasing expression of negative regulators IRAK-M, SHIP-1, suppressor of cytokine signaling 1 (SOCS1), and A20 (13, 16 -18).…”