Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
Crit Care. 2022 Jul 13;26(1):213. doi: 10.1186/s13054-022-04090-1.
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.
脓毒症是一种潜在的致命疾病，由机体对感染的免疫反应失调引起。脓毒症导致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后因素，有解剖学和不断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交流。脓毒症期间肠道屏障破坏和肠道微生物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。肝脏通过清除细菌、解毒脂多糖、释放细胞因子和急性期蛋白以及调节炎症代谢等机制，在全身感染期间对免疫防御至关重要。当肝脏发生不适当的免疫反应或过度炎症时，清除病原体的能力受损和肝代谢紊乱可导致肠道屏障进一步受损，肠道微生物组成和多样性增加。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密切的肠-肝相互作用（肠-肝轴）。
