Gut-liver crosstalk in sepsis-induced liver injury
by Jian Sun, Jingxiao Zhang, Xiangfeng Wang, Fuxi Ji,
Claudio Ronco, Jiakun Tian and Yongjie Yin
Critical Care volume 24,
Article number: 614 (2020)
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.
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