2023
DOI: 10.1097/mcc.0000000000001015
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Gut–lung crosstalk during critical illness

Abstract: Purpose of reviewStudy of organ crosstalk in critical illness has uncovered complex biological communication between different organ systems, but the role of microbiota in organ crosstalk has received limited attention. We highlight the emerging understanding of the gut–lung axis, and how the largest biomass of the human body in the gut may affect lung physiology in critical illness.Recent findingsDisruption of healthy gut microbial communities and replacement by disease-promoting pathogens (pathobiome) genera… Show more

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Cited by 12 publications
(11 citation statements)
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“…Such patients with gut-origin bacteria enrichment in their lungs (8.1%) had much worse survival than the rest of the cohort, and may represent a subset of patients in whom gut-to-lung bacterial translocation may have occurred. 36,37 Wider availability of BAL samples to investigate the alveolar spaces more closely can provide more evidence into the question of gut-to-lung translocation, but our non-invasive ETA samples showed that such translocation, if present, affects a small subset of patients at least within the first week of IMV. Therefore, efforts focused on preventing dysbiosis and pathogen colonization in the URT-to-LRT ecosystem may offer higher biological plausibility for measurable benefits in clinical trials.…”
Section: Discussionmentioning
confidence: 94%
“…Such patients with gut-origin bacteria enrichment in their lungs (8.1%) had much worse survival than the rest of the cohort, and may represent a subset of patients in whom gut-to-lung bacterial translocation may have occurred. 36,37 Wider availability of BAL samples to investigate the alveolar spaces more closely can provide more evidence into the question of gut-to-lung translocation, but our non-invasive ETA samples showed that such translocation, if present, affects a small subset of patients at least within the first week of IMV. Therefore, efforts focused on preventing dysbiosis and pathogen colonization in the URT-to-LRT ecosystem may offer higher biological plausibility for measurable benefits in clinical trials.…”
Section: Discussionmentioning
confidence: 94%
“…These data establish that postnatal colonization by intestinal commensal bacteria is pivotal in the development of the lung defenses of newborns. In addition, impairment of the gut barrier facilitates the translocation of microbial entities (living organisms or cellular fragments) to the pulmonary system ( Nath et al., 2023 ). Interactions between the host and gut microbiota within the mucosal lining of the gastrointestinal tract can exert an influence on lung physiology via secretion of microbial metabolites or transmission of host-derived messengers such as hormones, cytokines, or immune cells ( Ma et al., 2022 ).…”
Section: Discussionmentioning
confidence: 99%
“…Through this axis, microbes that generate a local immunomodulatory response to the body also elicit a systemic response. In addition, ectopic intestinal flora and metabolites (such as SCFA) can elicit extraintestinal organ-specific immune responses ( 72 ). Due to the crosstalk between lung and intestinal microbes, it has been shown that gut microbial dysbiosis is highly related to lung disorders, including chronic obstructive pulmonary disease, asthma, pulmonary hypertension, and lung cancer ( 71 ).…”
Section: Sources Of Specimens Of Microbesmentioning
confidence: 99%