脓毒症精准医疗新靶点——肠道菌群调节色氨酸代谢

A new target of precision medicine in sepsis:gut microbiome modified tryptophan metabolism

脓毒症是感染引起宿主反应失调进而导致危及生命的器官功能障碍。尽管抗感染、免疫调节和器官功能支持技术已取得长足进步,但由于"高异质性"的存在,脓毒症的精准、靶向诊治仍面临挑战。有研究显示,色氨酸(TRP)代谢紊乱是多种疾病发生的共性机制,参与免疫调节和多器官功能损伤。肠道菌群研究的兴起进一步凸显了肠道菌群调节TRP代谢在病原宿主交互和多器官系统"对话"中的关键作用,使其成为脓毒症精准医疗的潜在关键靶点。本文就TRP代谢、肠道菌群TRP代谢调节和脓毒症TRP代谢特征等进行综述,为临床进一步以TRP代谢为靶点开展脓毒症精准医疗提供线索。

Sepsis is a life-threatening organ dysfunction caused by dysregulated host responses to infection.Despite significant advances in anti-infective,immunomodulatory,and organ function support technologies,the precise and targeted management of sepsis remains a challenge due to its high heterogeneity.Studies have identified disturbed tryptophan(TRP)metabolism as a common mechanism in multiple diseases,which is involved in both immune regulation and the development of multi-organ damages.The rise of research on intestinal microflora has further highlighted the critical role of microflora-regulated TRP metabolism in pathogen-host interactions and the"cross-talk"among multi-organs,making it a potential key target for precision medicine in sepsis.This article reviews TRP metabolism,the regulation of TRP metabolism by the intestinal microflora,and the characteristics of TRP metabolism in sepsis,providing clues for further clinical targeting of TRP metabolism for precision medicine in sepsis.