TY - JOUR
T1 - Gut-lung crosstalk during critical illness
AU - Nath, Sridesh
AU - Kitsios, Georgios D.
AU - Bos, Lieuwe D. J.
N1 - Funding Information: Lieuwe D.J. Bos receives research funding from Amsterdam UMC., Longfonds, ERS, ZonMW and the Innovative Medicine Initiative. Dr Kitsios receives funding support from the National Institutes of Health: K23-HL139987 and R03-HL162655. Funding Information: Dr Kitsios has received research funding from Karius, Inc. The remaining authors have no conflicts of interest. Publisher Copyright: © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/4/1
Y1 - 2023/4/1
N2 - Purpose of reviewStudy 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 findingsDisruption 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.SummaryA 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.
AB - Purpose of reviewStudy 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 findingsDisruption 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.SummaryA 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.
KW - critical illness
KW - gut microbiome
KW - gut-lung axis
KW - pathobiome
UR - http://www.scopus.com/inward/record.url?scp=85149750105&partnerID=8YFLogxK
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85149750105&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/36762684
U2 - https://doi.org/10.1097/MCC.0000000000001015
DO - https://doi.org/10.1097/MCC.0000000000001015
M3 - Review article
C2 - 36762684
SN - 1070-5295
VL - 29
SP - 130
EP - 137
JO - Current Opinion in Critical Care
JF - Current Opinion in Critical Care
IS - 2
ER -