New insights into lipopolysaccharide inactivation mechanisms in sepsis
Open accessAbstract
The complex pathophysiology of sepsis makes it a syndrome with limited therapeutic options and a high mortality rate. Gram-negative bacteria containing lipopolysaccharides (LPS) in their outer membrane correspond to the most common cause of sepsis. Since the gut is considered an important source of LPS, intestinal damage has been considered a cause and a consequence of sepsis. Although important in the maintenance of the intestinal epithelial cell homeostasis, the microbiota has been considered a source of LPS. Recent studies have started to shed light on how sepsis is triggered by dysbiosis, and an increased inflammatory state of the intestinal epithelial cells, expanding the understanding of the gut-liver axis in sepsis. Here, we review the gut-liver interaction in Gram-negative sepsis, exploring the mechanisms of LPS inactivation, including the recently described contribution of an isoform of the cholesteryl-ester transfer protein (CETPI). Although several key questions remain to be answered when the pathophysiology of sepsis is reviewed, new contributions coming to light exploring the way LPS might be inactivated in vivo, suggest that new applications might soon reach the clinical setting.
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Sepsis induces gut dysbiosis via inflammation.
“Sepsis induces dysbiosis via ischemia, inflammation, and broad-spectrum antibiotics”
From Progress on the correlation between sepsis and gut microbiota: a narrative review (2026) · cites this paper as Pérez-Hernández et al., 2021
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Progress on the correlation between sepsis and gut microbiota: a narrative review
Yuan, Y., Li, J., & Yang, C. (2026) · Frontiers in microbiology · doi:10.3389/fmicb.2026.1862891 · Cited by 1 · see citing works
- Authors
- Pérez-Hernández, E. G., Delgado-Coello, B., Luna-Reyes, I., & Mas-Oliva, J.
- Affiliations
- Universidad Nacional Autónoma de México (MX)
- ORCID
- Luna-Reyes, Ismael
- Venue
- Biomedicine & Pharmacotherapy
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 141
- Pages
- 111890
- ISSN
- 0753-3322 (ISSN-L)
- OpenAlex
- W3178486726
- Cited by
- 56
- References
- 10
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 11 · 2023: 6 · 2022: 16 · 2021: 5
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Biomedicine & Pharmacotherapy (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Universidad Nacional Autónoma de México (IN206619, IN205717)
- Topics
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Life Sciences › Immunology and Microbiology › Immunology › Immune Response and Inflammation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- sepsis, lipopolysaccharide, Gram-negative bacteria, gut-liver axis, dysbiosis, intestinal epithelial cells, gut microbiota, cholesteryl ester transfer protein, intestinal barrier injury, inflammation
- MeSH terms
- Gastrointestinal Microbiome, Animals, Humans, Lipopolysaccharides, Sepsis, Cholesterol Ester Transfer Proteins
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