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Cited by 200Sepsis Diagnosis and TreatmentGut microbiota and healthLiver Disease and Transplantation

The gut-liver axis in sepsis: interaction mechanisms and therapeutic potential

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Zhang, Xue, Liu, Hong, Hashimoto, Kenji, Yuan, Shiying, Zhang, Jiancheng·2022·Critical Care
DOI 10.1186/s13054-022-04090-1PMC PMC9277879
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Abstract

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.

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  • Sepsis induces gut dysbiosis via ischemia.

    “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 Zhang et al., 2022

    The ‘Effects of sepsis on the intestinal barrier and microbiota’ section reports microbiota dysbiosis in septic patients. The paper does not link that dysbiosis to ischemia; its discussion of ischemia concerns liver injury, not the gut microbiota. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Bacterial translocation results in release of pathogen-associated molecular patterns and damage-associated molecular patterns into the liver, contributing to sepsis-induced liver injury.

    “Bacterial translocation results in the release of pathogen-associated molecular patterns (PAMPs) and damage-associated molecular patterns (DAMPs) into the liver, contributing to sepsis-induced liver injury [39].”

    From Gastrointestinal function and nutritional interventions in septic shock (2025) · cites this paper as [39]

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Cited by

Sorted by citations

Authors
Zhang, X., Liu, H., Hashimoto, K., Yuan, S., & Zhang, J.
Affiliations
  • Wuhan Union Hospital (CN)
  • Chiba University (JP)
Corresponding author
  • Hashimoto, Kenji
  • Yuan, Shiying
  • Zhang, Jiancheng
ORCID
Venue
Critical Care
Publisher
Springer Science and Business Media LLC
Published
2022-07-13
Volume
26
Issue
1
Pages
213-213
ISSN
1364-8535 (ISSN-L)
DOI
10.1186/s13054-022-04090-1
PMC
PMC9277879
OpenAlex
W4285086779
Cited by
200
References
20
Citations by year
2026: 51 · 2025: 56 · 2024: 50 · 2023: 39 · 2022: 4
FWCI
5.96
Type
journal article
Language
en
Open access
Licence
Locations
  • Critical Care (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Japan Society for the Promotion of Science (21H00184, 21H05612)
  • National Key Research and Development Program of China (2021YFC2501800)
  • National Natural Science Foundation of China (82071480)
Topics
  • Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
Keywords
gut-liver axis, sepsis, sepsis-induced liver injury, intestinal barrier disruption, gut dysbiosis, pathogen-associated molecular patterns, damage-associated molecular patterns, lipopolysaccharide detoxification, cytokine production, acute phase proteins, hepatic metabolism, systemic inflammation, therapeutic target
MeSH terms
Humans, Inflammation, Intestinal Mucosa, Liver, Sepsis, Dysbiosis

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