“…Mitochondrial DNA (MT-DNA) is a member of a group of mitochondrial DAMPs (MT-DAMPs) released by injured or dying cells and is recognized by TLR9 due to encoded hypomethylated CpG motifs reminiscent of an ancestral bacterial origin (Zhang et al, 2010). MT-DNA levels have been previously shown to be elevated in the plasma of patients that develop ARDS and multi-organ dysfunction during sepsis, as well as during sterile injury including trauma, hemorrhagic shock and ischemiareperfusion (Faust et al, 2020;Hauser et al, 2010;Nakahira et al, 2013;Puskarich et al, 2012;Scozzi et al, 2019;Simmons et al, 2013). The release of MT-DNA is often accompanied by the release of other MT-DAMPs, such as N-formylated peptides, cytochrome c and cardiolipin, which collectively engage multiple TLRs and the Nformylated peptide receptor-1 that in turn not only induce inflammatory cytokine expression (Grazioli and Pugin, 2018;Wu et al, 2019;Zhang et al, 2014) but also the generation of reactive oxygen species and the facilitation of neutrophil trafficking and activation (Dorward et al, 2017;Nakayama and Otsu, 2018;Scozzi et al, 2019).…”