Postbiotics as potential new therapeutic agents for sepsis

Sepsis is the main cause of death in critically ill patients and gut microbiota dysbiosis plays a crucial role in sepsis.On the one hand,sepsis leads to the destruction of gut microbiota and induces and aggravates terminal organ dysfunction.On the other hand,the activation of pathogenic gut flora and the reduction in beneficial microbial products increase the susceptibility of the host to sepsis.Although probiotics or fecal microbiota transplantation preserve gut barrier function on multiple levels,their efficacy in sepsis with intestinal microbiota disruptions remains uncertain.Postbiotics consist of inactivated microbial cells or cell components.They possess antimicrobial,immunomodulatory,antioxidant and antiproliferative activities.Microbiota-targeted therapy strategies,such as postbiotics,may reduce the incidence of sepsis and improve the prognosis of patients with sepsis by regulating gut microbial metabolites,improving intestinal barrier integrity and changing the composition of the gut microbiota.They offer a variety of mechanisms and might even be superior to more conventional‘biotics’such as probiotics and prebiotics.In this review,we present an overview of the concept of postbiotics and summarize what is currently known about postbiotics and their prospective utility in sepsis therapy.Overall,postbiotics show promise as a viable adjunctive therapy option for sepsis.

Analysis of the clinical features and risk factors of death in patients with mushroom poisoning

Background:Wild edible mushrooms are rich in nutrition and popular with people;however,few laboratory studies are available about the predictability of outcomes among patients with mushroom poisoning.Therefore,this study aimed to analyze the clinical features and death risk factors of patients with mushroom poisoning.Methods:Patients with mushroom poisoning admitted to the hospital from 2015 to 2021 were retrospectively evaluated.Results:A total of 197 patients with mushroom poisoning were enrolled in this study,of which 100(50.76%)were males,and the mortality was 10.66%(21/197).Patients who died were more likely to have demonstrated a long latency,high alanine aminotransferase,aspartate aminotransferase,direct bilirubin,total bilirubin(TB),activated partial thromboplastin time,prothrombin time,international normalized ratio,creatinine,and blood urea nitrogen.Multiple logistic regression analysis indicated that TB level greater than or equal to 34.2μmol/L had the greatest lethal risk and could increase the risk of death by 14.588 times(odds ratio:15.588;95%confidence interval:2.088-116.351),which indicated that TB was an independent risk factor of death in patients with acute mushroom poisoning.Conclusion:Bilirubin concentration was associated with the increased likelihood of mortality.Total bilirubin was the independent risk factor of mushroom poisoning.