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

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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

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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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Authors: Alverdy, J. C., Laughlin, R. S., & Wu, L.
Affiliations: University of Chicago Medical Center (US)
ORCID: Alverdy, John C.
Venue: Critical Care Medicine
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2003-02
Volume: 31
Issue: 2
Pages: 598-607
ISSN: 0090-3493 (ISSN-L)
DOI: 10.1097/01.ccm.0000045576.55937.67
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 › Critical Care and Intensive Care Medicine › 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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Influence of the critically ill state on host-pathogen interactions within the intestine: Gut-derived sepsis redefined

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