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Gut-Lung Crosstalk in Sepsis-Induced Acute Lung Injury
Open accessAbstract
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common acute and severe cases of the respiratory system with complicated pathogenesis and high mortality. Sepsis is the leading indirect cause of ALI/ARDS in the intensive care unit (ICU). The pathogenesis of septic ALI/ARDS is complex and multifactorial. In the development of sepsis, the disruption of the intestinal barrier function, the alteration of gut microbiota, and the translocation of the intestinal microbiome can lead to systemic and local inflammatory responses, which further alter the immune homeostasis in the systemic environment. Disruption of homeostasis may promote and propagate septic ALI/ARDS. In turn, when ALI occurs, elevated levels of inflammatory cytokines and the shift of the lung microbiome may lead to the dysregulation of the intestinal microbiome and the disruption of the intestinal mucosal barrier. Thus, the interaction between the lung and the gut can initiate and potentiate sepsis-induced ALI/ARDS. The gut–lung crosstalk may be a promising potential target for intervention. This article reviews the underlying mechanism of gut-lung crosstalk in septic ALI/ARDS.
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“The inflammatory cascade stemming from GI-released bacteria and endotoxins can exacerbate pulmonary dysfunction, leading to acute respiratory distress syndrome (ARDS) [27], worsening pulmonary outcomes [28].”
From Gastrointestinal function and nutritional interventions in septic shock (2025) · cites this paper as [27]
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BackgroundAlterations of the murine gut microbiome with age and allergic airway disease
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“It is worth noting that the mortality rate of ARDS caused by sepsis is higher than that of ARDS caused by other factors (Chen et al., 2019).”
BackgroundDiagnosis and management of acute respiratory distress syndrome
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“Depletion of intestinal microbiota with broad-spectrum antibiotics could exacerbate lung and intestinal damage and increase the mortality in sepsis (Xu et al., 2021).”
BackgroundThe lung lesion in four different types of shock in rabbits
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“When the bacterial burden of the gut is minimized, the inflammation and injury sustained with distal organs are lessened during sepsis (Cuevas et al., 1972).”
BackgroundStool Short-Chain Fatty Acids in Critically Ill Patients with Sepsis
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BackgroundIndole signaling decreases biofilm formation and related virulence of Listeria monocytogenes
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Background
Cited by
Sorted by citations
Lung microbiome: new insights into the pathogenesis of respiratory diseases
Li, R., Li, J., & Zhou, X. (2024) · Signal Transduction and Targeted Therapy · doi:10.1038/s41392-023-01722-y · Cited by 483
“16,137,138 The gut-lung axis is bidirectional, which means that the lung can affect gut homeostasis.”
BackgroundSelf-citationAcute lung injury caused by sepsis: how does it happen?
Sun, B., Lei, M., Zhang, J., Kang, H., Liu, H., & Zhou, F. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1289194 · Cited by 154
“It is also one of the most important causes of death of critically ill patients (4, 5).”
BackgroundQiu, F.-S., Wang, J., Guo, M.-Y., Li, X.-J., Shi, C.-Y., Wu, F., Zhang, H., Ying, H., & Yu, C.-H. (2023) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2023.115007 · Cited by 110
Exploring immune-related pathogenesis in lung injury: Providing new insights Into ALI/ARDS
Zheng, J., Li, Y., Kong, X., & Guo, J. (2024) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2024.116773 · Cited by 115
The leaky gut and the gut microbiome in sepsis – targets in research and treatment
Chancharoenthana, W., Kamolratanakul, S., Schultz, M. J., & Leelahavanichkul, A. (2023) · Clinical Science · doi:10.1042/cs20220777 · Cited by 86
Metadata
- Authors
- Zhou, X., & Liao, Y.
- Affiliations
- Wuhan University (CN)
- Corresponding author
- Zhou, Xin
- ORCID
- Zhou, Xin
- Venue
- Frontiers in Microbiology
- Publisher
- Frontiers Media SA
- Published
- 2021-12-23
- Volume
- 12
- Pages
- 779620-779620
- ISSN
- 1664-302X (ISSN-L)
- PMC
- PMC8733643
- OpenAlex
- W4200159901
- Cited by
- 153
- References
- 115
- Citations by year
- 2026: 36 · 2025: 48 · 2024: 38 · 2023: 25 · 2022: 6
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Microbiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- sepsis, acute lung injury, acute respiratory distress syndrome, intestinal barrier dysfunction, gut microbiota, lung microbiome, inflammatory cytokines, immune dysregulation, sepsis pathogenesis
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