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细菌从胃肠道的移位。

Bacterial translocation from the gastrointestinal tract.

作者信息

Berg R D

机构信息

Department of Microbiology and Immunology, Louisiana State University Medical Center-Shreveport 71130, USA.

出版信息

Adv Exp Med Biol. 1999;473:11-30. doi: 10.1007/978-1-4615-4143-1_2.

Abstract

Bacterial translocation is defined as the passage of viable bacteria from the gastrointestinal (GI) tract to extraintestinal sites, such as the mesenteric lymph node complex (MLN), liver, spleen, kidney, and bloodstream. The three primary mechanisms promoting bacterial translocation in animal models are identified as: (a) disruption of the ecologic GI equilibrium to allow intestinal bacterial overgrowth, (b) increased permeability of the intestinal mucosal barrier, and (c) deficiencies in host immune defenses. These mechanisms can act in concert to promote synergistically the systemic spread of indigenous translocating bacteria to cause lethal sepsis. In animal models in which the intestinal barrier is not physically damaged, indigenous bacteria translocate by an intracellular route through the epithelial cells lining the intestines and then travel via the lymph to the MLN. In animal models exhibiting damage to the mucosal epithelium, indigenous bacteria translocate intercellularly between the epithelial cells to directly access the blood. Indigenous GI bacteria have been cultured directly from the MLN of various types of patients. Thus, evidence is accumulating that translocation of indigenous bacteria from the GI tract is an important early step in the pathogenesis of opportunistic infections originating from the GI tract.

摘要

细菌移位被定义为活细菌从胃肠道转移至肠外部位,如肠系膜淋巴结复合体、肝脏、脾脏、肾脏及血流。在动物模型中,促进细菌移位的三个主要机制被确定为:(a)破坏胃肠道生态平衡以允许肠道细菌过度生长;(b)肠黏膜屏障通透性增加;(c)宿主免疫防御功能缺陷。这些机制可协同作用,促进内源性移位细菌的全身播散,导致致死性败血症。在肠道屏障未受到物理损伤的动物模型中,内源性细菌通过细胞内途径穿过肠道上皮细胞,然后经淋巴到达肠系膜淋巴结。在表现出黏膜上皮损伤的动物模型中,内源性细菌在上皮细胞间进行细胞间移位,直接进入血液。已从各类患者的肠系膜淋巴结中直接培养出内源性胃肠道细菌。因此,越来越多的证据表明,胃肠道内源性细菌的移位是源自胃肠道的机会性感染发病机制中的一个重要早期步骤。

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