Once released from hemoglobin polypeptide chains, heme binds to many extracellularcomponents, from phospholipid membranes(8) to proteins such as albumin andhemopexin (Hx).(9) Free heme has been related to an increased mortalityin sepsis(10) and to the severe systemic manifestations ofmalaria.(11) Free heme can also stimulate a pro-oxidantreaction(12,13) and can augment inflammatory reactions by directlystimulating toll-like receptor 4 (TLR4).(14) Neurons were found to be moresensitive to the toxic effects of heme than astrocytes, which contributes toperpetuating brain injury.(15). This evidence concerns the gene TLR4 and Sepsis.