脓毒症肠道微环境变化的研究进展

The intestinal microenvironment in sepsis

胃肠道被称为多脏器功能衰竭的"始动"器官。胃肠道微环境由单层肠上皮细胞层,局部免疫系统,微生物组组成,这三个组成部分在维持健康宿主的自稳态方面发挥了重要作用。然而,脓毒症时肠道微环境发生改变,导致病理改变引起局部和远隔脏器的损伤。本综述重点关注了生理和病理状态下上皮细胞,胃肠道淋巴细胞,共生菌三者之间的关系,并且如何以微生态为靶向治疗使脓毒症患者获益。

The gastrointestinal tract has long been hypothesized to function as ＂the motor＂ of multiple organ dysfunc-tion syndrome. The gastrointestinal microenvironment consists of a single layer of epithelium, a local immune system, and the microbiome. These three components of the intestine together play a crucial role in maintaining homeostasis dur- ing times of health. Each of these is interconnected and essential to maintaining host health. However, the gastrointestinal microenvironment is perturbed during sepsis. Sepsis changes the symbiotic intestinal microenvironment into a dysbiotic environment that promotes epithelial cell hyperpermeability and apoptosis, excessive inflammation, and colonization by pathogenic bacteria, resulting in pathologic changes that drive both local and distant injury. This review focuses on the relationship among the epithelium, gastrointestinal lymphocytes, and commensal bacteria during basal and pathologic condi- tions and how the intestinal microenvironment may be targeted {or therapeutic gain in septic patients.