肠-肺轴与脓毒症相关急性肺损伤:从菌群代谢到免疫调控的机制与展望OA

Sepsis-associated acute lung injury(SALI)is one of the common complications of sepsis,characterized by high mortality and complex pathophysiological mechanisms.Recent studies have demonstrated that gut microbiota and their metabolites participate in the progression of SALI via the gut-lung axis,influencing the local microenvironment and immune responses of lung tissue at multiple levels,through diverse targets,and across various stages.Firstly,this review systematically summarizes the multidimensional regulatory mechanisms of the gut-lung axis in SALI.Beginning with the role of the gut-lung axis in the pathophysiology of SALI,it elucidates the anatomical and functional connections of the gut-lung axis.It then focuses on analyzing the immunomodulatory effects of gut microbiota and their metabolites(such as short-chain fatty acids,bile acids,and tryptophan,etc.)in SALI,and discusses the interplay among different metabolic pathways.Secondly,the review emphasizes the roles of gut barrier dysfunction and bacterial translocation in SALI pathogenesis.Finally,it identifies key unresolved issues currently facing the field and outlines future research directions,with the aim of broadening the understanding of the SALI pathogenesis and providing a theoretical foundation and translational opportunities for developing novel effective interventions.