TY - JOUR
T1 - Leveraging the microbiome in the treatment of sepsis
T2 - potential pitfalls and new perspectives
AU - Biemond, Jason J.
AU - McDonald, Braedon
AU - Haak, Bastiaan W.
N1 - Funding Information: BM receives research funding from the Canadian Institutes of Health Research (CIHR), Canadian Foundation for Innovation (CFI), and Alberta Health Services. BWH is supported by a Niels Stensen Fellowship. Publisher Copyright: © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2023/4/1
Y1 - 2023/4/1
N2 - Purpose of reviewThis review aims to provide an overview of the current knowledge about microbiota-targeted therapies in sepsis, and calls out - despite recent negative studies - not to halt our efforts of translating these tools into regular medical practice.Recent findingsThe intestinal microbiome has an important role in shaping our immune system, and microbiota-derived metabolites prime innate and adaptive inflammatory responses to infectious pathogens. Microbiota composition is severely disrupted during sepsis, which has been linked to increased risk of mortality and secondary infections. However, efforts of using these microbes as a tool for prognostic or therapeutic purposes have been unsuccessful so far, and recent trials studying the impact of probiotics in critical illness did not improve patient outcomes. Despite these negative results, researchers must continue their attempts of harnessing the microbiome to improve sepsis survival in patients with a high risk of clinical deterioration. Promising research avenues that could potentially benefit sepsis patients include the development of next-generation probiotics, use of the microbiome as a theranostic tool to direct therapy, and addressing the restoration of microbial communities following ICU discharge.SummaryAlthough research focused on microbiome-mediated therapy in critically ill patients has not yielded the results that were anticipated, we should not abandon our efforts to translate promising preclinical findings into clinical practice.
AB - Purpose of reviewThis review aims to provide an overview of the current knowledge about microbiota-targeted therapies in sepsis, and calls out - despite recent negative studies - not to halt our efforts of translating these tools into regular medical practice.Recent findingsThe intestinal microbiome has an important role in shaping our immune system, and microbiota-derived metabolites prime innate and adaptive inflammatory responses to infectious pathogens. Microbiota composition is severely disrupted during sepsis, which has been linked to increased risk of mortality and secondary infections. However, efforts of using these microbes as a tool for prognostic or therapeutic purposes have been unsuccessful so far, and recent trials studying the impact of probiotics in critical illness did not improve patient outcomes. Despite these negative results, researchers must continue their attempts of harnessing the microbiome to improve sepsis survival in patients with a high risk of clinical deterioration. Promising research avenues that could potentially benefit sepsis patients include the development of next-generation probiotics, use of the microbiome as a theranostic tool to direct therapy, and addressing the restoration of microbial communities following ICU discharge.SummaryAlthough research focused on microbiome-mediated therapy in critically ill patients has not yielded the results that were anticipated, we should not abandon our efforts to translate promising preclinical findings into clinical practice.
KW - critical illness
KW - microbiome
KW - microbiota-targeted therapies
KW - probiotics
UR - http://www.scopus.com/inward/record.url?scp=85149762285&partnerID=8YFLogxK
U2 - https://doi.org/10.1097/MCC.0000000000001019
DO - https://doi.org/10.1097/MCC.0000000000001019
M3 - Review article
C2 - 36762681
SN - 1070-5295
VL - 29
SP - 123
EP - 129
JO - Current Opinion in Critical Care
JF - Current Opinion in Critical Care
IS - 2
ER -