Research Institute of General Surgery, Jinling Hospital, Medical School, Nanjing University, Nanjing, China.
Front Immunol. 2019 Aug 7;10:1873. doi: 10.3389/fimmu.2019.01873. eCollection 2019.
Gut-derived infection is among the most common complications in patients who underwent severe trauma, serious burn, major surgery, hemorrhagic shock or severe acute pancreatitis (SAP). It could cause sepsis and multiple organ dysfunction syndrome (MODS), which are regarded as a leading cause of mortality in these cases. Gut-derived infection is commonly caused by pathological translocation of intestinal bacteria or endotoxins, resulting from the dysfunction of the gut barrier. In the last decades, the studies regarding to the pathogenesis of gut-derived infection mainly focused on the breakdown of intestinal epithelial tight junction and increased permeability. Limited information is available on the roles of intestinal microbial barrier in the development of gut-derived infection. Recently, advances of next-generation DNA sequencing techniques and its utilization has revolutionized the gut microecology, leading to novel views into the composition of the intestinal microbiota and its connections with multiple diseases. Here, we reviewed the recent progress in the research field of intestinal barrier disruption and gut-derived infection, mainly through the perspectives of the dysbiosis of intestinal microbiota and its interaction with intestinal mucosal immune cells. This review presents novel insights into how the gut microbiota collaborates with mucosal immune cells to involve the development of pathological bacterial translocation. The data might have important implication to better understand the mechanism underlying pathological bacterial translocation, contributing us to develop new strategies for prevention and treatment of gut-derived sepsis.
肠源性感染是严重创伤、严重烧伤、大手术、失血性休克或重症急性胰腺炎（SAP）患者最常见的并发症之一。它可导致脓毒症和多器官功能障碍综合征（MODS），这被认为是这些情况下死亡的主要原因。肠源性感染通常是由肠道细菌或内毒素的病理移位引起的，这是由于肠道屏障功能障碍所致。在过去的几十年中，关于肠源性感染发病机制的研究主要集中在肠上皮紧密连接的破坏和通透性增加上。关于肠道微生物屏障在肠源性感染发展中的作用的信息有限。最近，下一代 DNA 测序技术的进步及其应用彻底改变了肠道微生态学，为肠道微生物群的组成及其与多种疾病的关系提供了新的视角。在这里，我们综述了肠道屏障破坏和肠源性感染研究领域的最新进展，主要是通过肠道微生物失调及其与肠道黏膜免疫细胞的相互作用的角度。这篇综述为肠道微生物群如何与黏膜免疫细胞合作参与病理性细菌易位的发展提供了新的见解。这些数据可能对更好地理解病理性细菌易位的机制具有重要意义，并有助于我们开发预防和治疗肠源性脓毒症的新策略。
