Department of Critical Care Medicine, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, Jiangsu, People's Republic of China.
Drug Des Devel Ther. 2022 Jun 4;16:1697-1711. doi: 10.2147/DDDT.S360348. eCollection 2022.
Intestinal barrier injury and hyperglycemia are common in patients with sepsis. Bacteria translocation and systemic inflammatory response caused by intestinal barrier injury play a significant role in sepsis occurrence and deterioration, while hyperglycemia is linked to adverse outcomes in sepsis. Previous studies have shown that hyperglycemia is an independent risk factor for intestinal barrier injury. Concurrently, increasing evidence has indicated that some anti-hyperglycemic agents not only improve intestinal barrier function but are also beneficial in managing sepsis-induced organ dysfunction. Therefore, we assume that these agents can block or reduce the severity of sepsis by improving intestinal barrier function. Accordingly, we explicated the connection between sepsis, intestinal barrier, and hyperglycemia, overviewed the evidence on improving intestinal barrier function and alleviating sepsis-induced organ dysfunction by anti-hyperglycemic agents (eg, metformin, peroxisome proliferators activated receptor-γ agonists, berberine, and curcumin), and summarized some common characteristics of these agents to provide a new perspective in the adjuvant treatment of sepsis.
肠道屏障损伤和高血糖在脓毒症患者中很常见。肠道屏障损伤引起的细菌易位和全身炎症反应在脓毒症的发生和恶化中起重要作用，而高血糖与脓毒症的不良结局有关。既往研究表明，高血糖是肠道屏障损伤的独立危险因素。同时，越来越多的证据表明，一些降糖药物不仅改善肠道屏障功能，而且对脓毒症引起的器官功能障碍也有益。因此，我们假设这些药物可以通过改善肠道屏障功能来阻断或减轻脓毒症的严重程度。因此，我们阐述了脓毒症、肠道屏障和高血糖之间的关系，综述了降糖药物（如二甲双胍、过氧化物酶体增殖物激活受体-γ 激动剂、小檗碱和姜黄素）改善肠道屏障功能和减轻脓毒症引起的器官功能障碍的证据，并总结了这些药物的一些共同特征，为脓毒症的辅助治疗提供了一个新视角。
