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The gut–liver axis in sepsis: interaction mechanisms and therapeutic potential
Critical Care ( IF 15.1 ) Pub Date : 2022-07-13 , DOI: 10.1186/s13054-022-04090-1
Xue Zhang 1, 2 , Hong Liu 1, 2 , Kenji Hashimoto 3 , Shiying Yuan 1, 2 , Jiancheng Zhang 1, 2
Affiliation  

Sepsis is a potentially fatal condition caused by dysregulation of the body's immune response to an infection. Sepsis-induced liver injury is considered a strong independent prognosticator of death in the critical care unit, and there is anatomic and accumulating epidemiologic evidence that demonstrates intimate cross talk between the gut and the liver. Intestinal barrier disruption and gut microbiota dysbiosis during sepsis result in translocation of intestinal pathogen-associated molecular patterns and damage-associated molecular patterns into the liver and systemic circulation. The liver is essential for regulating immune defense during systemic infections via mechanisms such as bacterial clearance, lipopolysaccharide detoxification, cytokine and acute-phase protein release, and inflammation metabolic regulation. When an inappropriate immune response or overwhelming inflammation occurs in the liver, the impaired capacity for pathogen clearance and hepatic metabolic disturbance can result in further impairment of the intestinal barrier and increased disruption of the composition and diversity of the gut microbiota. Therefore, interaction between the gut and liver is a potential therapeutic target. This review outlines the intimate gut–liver cross talk (gut–liver axis) in sepsis.

中文翻译:

脓毒症中的肠-肝轴:相互作用机制和治疗潜力

脓毒症是一种潜在的致命疾病,由身体对感染的免疫反应失调引起。脓毒症引起的肝损伤被认为是重症监护病房死亡的一个强有力的独立预测因素,并且有解剖学和积累的流行病学证据表明肠道和肝脏之间存在密切的相互作用。脓毒症期间肠道屏障破坏和肠道微生物群失调导致肠道病原体相关分子模式和损伤相关分子模式易位到肝脏和全身循环中。肝脏对于通过细菌清除、脂多糖解毒、细胞因子和急性期蛋白释放以及炎症代谢调节等机制调节全身感染期间的免疫防御至关重要。当肝脏发生不适当的免疫反应或严重的炎症时,病原体清除能力受损和肝脏代谢紊乱会导致肠道屏障进一步受损,并增加肠道微生物群的组成和多样性的破坏。因此,肠道和肝脏之间的相互作用是一个潜在的治疗靶点。这篇综述概述了脓毒症中亲密的肠-肝串扰(肠-肝轴)。
更新日期:2022-07-13
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