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Myelodysplastic syndromes (MDS) constitute a group of clonal bone marrow (BM) problems characterized by ineffective hematopoiesis, peripheral blood cytopenias along with a higher danger of transformation to acute myeloid leukemia.1 Lots of models happen to be generated to unravel the complex pathophysiological method(es) leading to MDS development and progression. Excessive pro-inflammatory and inhibitory cytokine production in MDS BM has been recognized as a prominent pathogenic mechanism that disrupts hematopoiesis by inducing the apoptotic death with the BM progenitor/precursor cells.2-4 In accordance with all the aberrant cytokine production within the marrow microenvironment may be the constitutively activated p38 mitogen activated protein kinase (MAPK) and nuclear aspect kappa B (NFB) molecular pathways in BM cellular subsets of?013 Ferrata Storti Foundation. That is an open-access paper. doi:ten.3324/haematol.2012.064642 The on the internet version of this short article includes a Supplementary Appendix. Manuscript received on February 19, 2012. Manuscript accepted on January 28, 2013. Correspondence: [email protected] haematologica | 2013; 98(eight)?Fe N o rra co ta m S m to er rt ci i F al o us un e da tio nABSTRACTMDS sufferers.five,six Nevertheless, the upstream pathways, the precise cellular source and also the triggering events connected to this cytokine excess in MDS BM remain unknown. Toll-like receptors (TLRs) are a.