Challenge to the Intestinal Mucosa During Sepsis

Conclusion The impact of sepsis on the gut is manifold, e.g., sepsis mediated alteration of the gut-blood barrier and increase in the intestinal permeability, which may correlate with the phenomena of bacterial translocation and lymphatic activation (“toxic-lymph”). Systemic consequences of sepsis are widespread and concern to the coagulative system, the microbiome as well as enzymes, such as pancreatic proteases, MMPs and IAPs. Nevertheless, the therapeutic approaches for modulating the mucosal immune system are still rarely effective in daily routine. Recent published studies showing that treatment with FMT, probiotics and synbiotics are new concepts for gut-specific therapeutic prevention of sepsis (Table 1). Since the past decade, several clinical trials have been completed and are underway to comprehensively actualize the currently understood putative effectiveness of targeting the gut during sepsis. This has been presented in Table 1, enlisting all completed published, completed unpublished and ongoing trials so far. One exemplary study was proven to be an effective synbiotic treatment of fructooligosaccharides and Lactoacillus plantarum to preterm neonates which prevented sepsis and mortality in the treatment group (181). However, these promising therapeutic approaches are yet to be appraised as accepted therapeutic options. More clinical investigations could help substantiate these findings and extend them into becoming alternative treatment options. This...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research

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