Tsujimoto Hironori, Ono Satoshi, Mochizuki Hidetaka
Department of Surgery, National Defense Medical College, Tokorozawa, Japan.
Dig Surg. 2009;26(2):100-9. doi: 10.1159/000206143. Epub 2009 Mar 2.
BACKGROUND/AIM: Unlike animals, the incidence of bacterial translocation and its clinical significance remain to be determined in humans, which may be due to the lack of accurate methods to confirm and monitor bacterial translocation. The literature on the consequences of novel insights of bacterial translocation was reviewed.
The Medline databases were searched for publications regarding translocation of bacteria as well as pathogen-associated molecular patterns.
Although substantial data support the occurrence of bacterial translocation in humans, the lack of data correlating bacterial translocation with its clinical significance has lead to confusion among physicians. Toll-like receptors have been implicated in the mediation of systemic responses to the relevant pathogen-associated molecular pattern. The gut is a reservoir of pathogen-associated molecular patterns from microbes, and translocation of pathogen-associated molecular patterns other than endotoxin also induces a systemic inflammatory response through toll-like receptors.
Pathogen-associated molecular patterns translocation may be at least partly responsible for the development of sepsis under conditions in which bacterial translocation may occur. Detection of bacterial DNA in blood and tissues/organs should be useful as a marker of translocation of pathogen-associated molecular patterns and/or bacterial translocation, and should have the predictive value for developing sepsis in surgical patients.
背景/目的：与动物不同，细菌移位在人类中的发生率及其临床意义尚待确定，这可能是由于缺乏准确的方法来确认和监测细菌移位。本文综述了有关细菌移位新见解后果的文献。
检索Medline数据库中有关细菌移位以及病原体相关分子模式的出版物。
尽管大量数据支持人类中细菌移位的发生，但缺乏将细菌移位与其临床意义相关联的数据导致医生之间存在困惑。Toll样受体参与了对相关病原体相关分子模式的全身反应的介导。肠道是微生物病原体相关分子模式的储存库，除内毒素外的病原体相关分子模式的移位也通过Toll样受体诱导全身炎症反应。
在可能发生细菌移位的情况下，病原体相关分子模式移位可能至少部分导致脓毒症的发生。检测血液和组织/器官中的细菌DNA作为病原体相关分子模式和/或细菌移位的标志物应该是有用的，并且对手术患者发生脓毒症具有预测价值。
