TY - JOUR
T1 - Gut microbiota and sepsis
T2 - From pathogenesis to novel treatments
AU - Kullberg, Robert F. J.
AU - Wiersinga, W. Joost
AU - Haak, Bastiaan W.
N1 - Funding Information: The work was supported by the Netherlands Organization for Scientific Research [VIDI grant #91716475 to WJW]. Publisher Copyright: © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Purpose of review This review summarizes recent progress in our understanding of the role of the gut microbiota in sepsis pathogenesis and outlines the potential role of microbiota-targeted therapies. Recent findings The composition of the gut microbiome is profoundly distorted during sepsis, with a loss of commensal bacteria and an overgrowth of potential pathogenic micro-organisms. These alterations also extend to nonbacterial intestinal inhabitants. Disruptions of these intestinal communities are associated with both an increased susceptibility to develop sepsis, as well as a higher risk of adverse outcomes. Preclinical studies have characterized the effects of several microbiota-derived metabolites (such as D-lactate, butyrate, and deoxycholic acid) on enhancing the host immune response during critical illness. Microbiota-targeted therapies (e.g. probiotics or fecal microbiota transplantation) might be of benefit, but can also be associated with increased risks of bloodstream infections. Summary Emerging evidence display an important role of gut micro-organisms (including bacteria, fungi, eukaryotic viruses, and bacteriophages) and their derived metabolites in both the susceptibility to, as well as outcomes of sepsis. Despite recent progress in the mechanistic understanding of microbiota-mediated protection, clinical breakthroughs in the development of microbiota-based prognostic tools or therapies are thus far lacking in the field of sepsis.
AB - Purpose of review This review summarizes recent progress in our understanding of the role of the gut microbiota in sepsis pathogenesis and outlines the potential role of microbiota-targeted therapies. Recent findings The composition of the gut microbiome is profoundly distorted during sepsis, with a loss of commensal bacteria and an overgrowth of potential pathogenic micro-organisms. These alterations also extend to nonbacterial intestinal inhabitants. Disruptions of these intestinal communities are associated with both an increased susceptibility to develop sepsis, as well as a higher risk of adverse outcomes. Preclinical studies have characterized the effects of several microbiota-derived metabolites (such as D-lactate, butyrate, and deoxycholic acid) on enhancing the host immune response during critical illness. Microbiota-targeted therapies (e.g. probiotics or fecal microbiota transplantation) might be of benefit, but can also be associated with increased risks of bloodstream infections. Summary Emerging evidence display an important role of gut micro-organisms (including bacteria, fungi, eukaryotic viruses, and bacteriophages) and their derived metabolites in both the susceptibility to, as well as outcomes of sepsis. Despite recent progress in the mechanistic understanding of microbiota-mediated protection, clinical breakthroughs in the development of microbiota-based prognostic tools or therapies are thus far lacking in the field of sepsis.
KW - fecal microbiota transplantation
KW - microbiota
KW - probiotics
KW - sepsis
UR - http://www.scopus.com/inward/record.url?scp=85117848653&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/MOG.0000000000000781
DO - https://doi.org/10.1097/MOG.0000000000000781
M3 - Review article
C2 - 34419965
SN - 0267-1379
VL - 37
SP - 578
EP - 585
JO - Current opinion in gastroenterology
JF - Current opinion in gastroenterology
IS - 6
ER -