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Cited by 18Gut microbiota and healthNosocomial Infections in ICUSepsis Diagnosis and Treatment

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Gut–lung crosstalk during critical illness

Open access
Nath, Sridesh, Kitsios, Georgios D., Bos, Lieuwe D.J.·2023·Current Opinion in Critical Care
DOI 10.1097/mcc.0000000000001015
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Abstract

Purpose of review: Study of organ crosstalk in critical illness has uncovered complex biological communication between different organ systems, but the role of microbiota in organ crosstalk has received limited attention. We highlight the emerging understanding of the gut–lung axis, and how the largest biomass of the human body in the gut may affect lung physiology in critical illness. Recent findings: Disruption of healthy gut microbial communities and replacement by disease-promoting pathogens (pathobiome) generates a maladaptive transmitter of messages from the gut to the lungs, connected via the portal venous and the mesenteric lymphatic systems. Gut barrier impairment allows for microbial translocation (living organisms or cellular fragments) to the lungs. Host-microbiota interactions in the gut mucosa can also impact lung physiology through microbial metabolite secretion or host-derived messengers (hormones, cytokines or immune cells). Clinical examples like the prevention of ventilator-associated pneumonia by selective decontamination of the digestive tract show that the gut–lung axis can be manipulated therapeutically. Summary: A growing body of evidence supports the pathophysiological relevance of the gut–lung axis, yet we are only at the brink of understanding the therapeutic and prognostic relevance of the gut microbiome, metabolites and host-microbe interactions in critical illness.

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    From Gastrointestinal function and nutritional interventions in septic shock (2025) · cites this paper as [28]

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Metadata

Authors
Nath, S., Kitsios, G. D., & Bos, L. D. J.
Affiliations
  • Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine
  • University of Pittsburgh (US)
  • Amsterdam UMC Location University of Amsterdam (NL)
Corresponding author
  • Kitsios, Georgios D.
  • Bos, Lieuwe D.J.
ORCID
Venue
Current Opinion in Critical Care
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2023-01-24
Volume
29
Issue
2
Pages
130-137
ISSN
  • 1070-5295 (ISSN-L)
  • 1531-7072
DOI
10.1097/mcc.0000000000001015
OpenAlex
W4319826311
Cited by
18
References
4
Citations by year
2026: 2 · 2025: 4 · 2024: 7 · 2023: 5
FWCI
0.48
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Current Opinion in Critical Care (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (submittedVersion, other-oa)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
Funders
  • Amsterdam University Medical Centers
  • ZonMw
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (K23HL139987, R03HL162655)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
Keywords
gut-lung axis, critical illness, gut microbiota, pathobiome, microbial translocation, intestinal barrier dysfunction, host-microbe interactions, microbial metabolites, ventilator-associated pneumonia, selective decontamination of the digestive tract, cytokines, immune cells
MeSH terms
Gastrointestinal Microbiome, Humans, Lung, Cytokines, Critical Illness, Microbiota

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