Challenge to the Intestinal Mucosa During Sepsis

Abstract

Sepsis is a complex of life-threating organ dysfunction in critically ill patients, with a primary infectious cause or through secondary infection of damaged tissues. The systemic consequences of sepsis have been intensively examined and evidences of local alterations and repercussions in the intestinal mucosal compartment is gradually defining gut-associated changes during sepsis. In the present review, we focus on sepsis-induced dysfunction of the intestinal barrier, consisting of an increased permeability of the epithelial lining, which may facilitate bacterial translocation. We discuss disturbances in intestinal vascular tonus and perfusion and coagulopathies with respect to their proposed underlying molecular mechanisms. The consequences of enzymatic responses by pancreatic proteases, intestinal alkaline phosphatases, and several matrix metalloproteases are also described. We conclude our insight with a discussion on novel therapeutic interventions derived from crucial aspects of the gut mucosal dynamics during sepsis.

Fecal microbiota transplantation reconstructs the gut microbiota of septic mice and protects the intestinal mucosal barrier

“…Gut barrier dysfunction can be considered both a result and a cause of sepsis development [19]. There are four mechanisms associated with gut barrier failure.…”

“…Even though the evidence is limited to a series of case reports, the improved clinical outcomes in these patients following FMT are promising [16,18]. However, during sepsis, the exact mechanism of action for the use of FMT on the intestine is still unknown [19].…”

Skin manifestations of malnutrition in HIV-positive meningitis patients

“…Cranial nerve palsies causing dysphagia also decrease the nutrient intake. The altered gut absorption (Haussner et al 2019) and motility further cut down the nourishment. Antibiotic therapy-induced microbiota changes, the increased nutrient utilisation by the chronically overwrought immune system and the disease-induced stress deprive the patient of essential nutrients.…”

Цитоэнергетическая И Пробиотическая Оптимизация Интенсивной Терапии Синдрома Гастроинтестинальной Недостаточности У Новорожденных: Оценка Клинической Эффективности

“…Зважаючи на екстрагастроінтестинальні впливи СГІН, можна стверджувати, що зменшення вираженості цього синдрому нівелювало ефекти, пов'язані із бактеріальною транслокацією з кишечника, зокрема прояви ССЗВ [23,24].…”