Several mechanisms of the release of exosomal HMGB1 from cells have been revealed so far, such as the activation of TLR4 and caspase-11/gasdermin D (GSDMD) signaling, decreased autophagy and endoplasmic reticulum (ER) stress, all of which are important cellular mechanisms of sepsis pathophysiology (31–33). This evidence concerns the gene TLR4 and Sepsis.