Gut-liver crosstalk in sepsis-induced liver injury

Crit Care. 2020 Oct 19;24(1):614. doi: 10.1186/s13054-020-03327-1.

Abstract

Sepsis is characterized by a dysregulated immune response to infection leading to life-threatening organ dysfunction. Sepsis-induced liver injury is recognized as a powerful independent predictor of mortality in the intensive care unit. During systemic infections, the liver regulates immune defenses via bacterial clearance, production of acute-phase proteins (APPs) and cytokines, and metabolic adaptation to inflammation. Increased levels of inflammatory cytokines and impaired bacterial clearance and disrupted metabolic products can cause gut microbiota dysbiosis and disruption of the intestinal mucosal barrier. Changes in the gut microbiota play crucial roles in liver injury during sepsis. Bacterial translocation and resulting intestinal inflammation lead to a systemic inflammatory response and acute liver injury. The gut-liver crosstalk is a potential target for therapeutic interventions. This review analyzes the underlying mechanisms for the gut-liver crosstalk in sepsis-induced liver injury.

Keywords: Gut-liver crosstalk; Inflammation; Liver injury; Metabolism; Microbiota dysbiosis; Sepsis.

Publication types

  • Review

MeSH terms

  • Gastrointestinal Microbiome / physiology
  • Gastrointestinal Tract / physiopathology*
  • Humans
  • Liver / abnormalities
  • Liver / physiopathology*
  • Multiple Organ Failure / etiology
  • Multiple Organ Failure / physiopathology
  • Sepsis / complications*
  • Sepsis / physiopathology