Cited by 200Sepsis Diagnosis and TreatmentClinical Nutrition and GastroenterologyGut microbiota and health

Influence of the critically ill state on host-pathogen interactions within the intestine: gut-derived sepsis redefined

Alverdy, John C., Laughlin, Robert S., Wu, Licheng·2003·Critical Care Medicine

Abstract

Severe and prolonged states of catabolic stress have been shown to have profound effects on the intestinal tract microflora and intestinal function. Gut-derived sepsis is a term used to describe a state of systemic inflammation with organ dysfunction after severe catabolic stress hypothesized to be initiated and perpetuated by the intestinal tract microflora. Popular notions of the mechanism of this process have suggested that stress promotes the translocation of intestinal bacteria or their toxins into the systemic compartment resulting in the release of proinflammatory cytokines which participate in the systemic inflammatory response syndrome. This review is an attempt to redefine the mechanism of gut-derived sepsis by focusing on molecular events that result from host-pathogen interactions within the intestinal tract itself. This evidence-based review posits that gut-derived bacteremia, even with potent nosocomial pathogens, is an event of low proinflammatory potential and, itself, is an insufficient stimulus for the systemic inflammatory response and organ failure state typically seen after severe and prolonged catabolic stress. Mechanisms of this apparent paradox are discussed.

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Crossref · 10.1097/01.ccm.0000045576.55937.67

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61 of 61 references verified0 citation errors · 0 not checkable

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  • Translocation of microbes and microbial products is not necessary for the microbiome to cause systemic inflammation and injury.

    “translocation of microbes and microbial products is not necessary for the microbiome to cause systemic inflammation and injury.”

    From The microbiome and critical illness (2016) · cites this paper as [105]

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Authors
Alverdy, J. C., Laughlin, R. S., & Wu, L.
Affiliations
University of Chicago Medical Center (US)
Venue
Critical Care Medicine
Published
2003-02
Volume
31
Issue
2
Pages
598-607
ISSN
0090-3493 (ISSN-L)
OpenAlex
W1997883951
Cited by
200
References
61
Citations by year
2026: 1 · 2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 5 · 2019: 6 · 2018: 4 · 2017: 8 · 2016: 6 · 2015: 7 · 2014: 6 · 2013: 10 · 2012: 20
FWCI
2.21
Type
journal article
Language
en
Open access
closed
Locations
  • Critical Care Medicine (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of General Medical Sciences (R01GM062344, R01-GM-62344-01)
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords
gut-derived sepsis, host-pathogen interaction, gut microbiota, catabolic stress, nosocomial pathogens, systemic inflammatory response syndrome, inflammatory cytokines, organ dysfunction, intestinal barrier, critically ill patients
MeSH terms
Bacteria, Epithelium, Humans, Intestines, Virulence, Reperfusion Injury, Bacteremia, Critical Illness, Sepsis, Bacterial Translocation, Pancreatitis, Acute Necrotizing

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