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Microbes & Immunity

REVIEW ARTICLE
The roles and potential clinical implications of

gut microbiome in sepsis

Na Qin 1,2,3 , Hongyan Chen 1,2,3 , Hao Su 1,2,3,4 , Xiaoting Zhang 1,2,3,4 ,
5
Haiyun Shang 1,2,3,4 , Zihe Xu 1,2,3,4 , Zhenhua Zeng , and Huarong Chen 1,2,3,4 *
1 Department of Anaesthesia and Intensive Care and Peter Hung Pain Research Institute, The
Chinese University of Hong Kong, Hong Kong SAR, China
2 Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong SAR,
China
3 CUHK Shenzhen Research Institute, Shenzhen, Guangdong, China
4 State Key Laboratory of Digestive Diseases, The Chinese University of Hong Kong, Hong Kong
SAR, China
5 Department of Critical Care Medicine, Nanfang Hospital, Southern Medical University, Guangzhou,
Guangdong, China

Abstract
Pronounced dysbiosis in the gut microbiome is common among sepsis patients,
resulting in aggravation of the disease. This disturbance not only impacts gut
integrity but also initiates localized immune responses that may progress to systemic
inflammation. This review explores recent discoveries regarding the dysregulation
of the gut microbiome, alterations in gut permeability, and disruptions in intestinal
*Corresponding author: immune responses that occur during sepsis. In addition, we discuss innovative
Huarong Chen therapeutic strategies, encompassing the impacts of metabolites derived from
(hchen2@cuhk.edu.hk)
microbes, the selection of beneficial probiotics, and the utilization of fecal microbiota
Citation: Qin N, Chen H, Su H, transplantation in the management of sepsis. Understanding the complexities of the
et al. The roles and potential
clinical implications of gut gut microbiome holds the promise of revealing novel strategies that may transform
microbiome in sepsis. Microbes & the treatment of sepsis, providing a ray of hope for improved outcomes in critically
Immunity. 2025;2(1):3-16. ill patients.
doi: 10.36922/mi.4742
Received: September 2, 2024
Keywords: Sepsis; Gut microbiota; Metabolite; Dysbiosis; Immune response
Revised: October 15, 2024
Accepted: November 11, 2024
Published Online: December 2, 1. Introduction
2024
Copyright: © 2024 Author(s). Sepsis is a life-threatening disorder caused by the dysregulated host response to infection
This is an Open-Access article with a high risk of morbidity and mortality. This syndrome remains a global health
1
distributed under the terms of the
Creative Commons Attribution concern for the World Health Organization, dramatically influencing resource allocation
License, permitting distribution, and causing substantial economic ramifications. In the United States, sepsis incurs
2,3
and reproduction in any medium,
provided the original work is nearly $24 billion in health-care costs annually, surpassing many other diseases, despite
4,5
properly cited. constituting a relatively small portion of hospitalization. Recognized through clinical
Publisher’s Note: AccScience signs and a diverse array of symptoms, sepsis involves a complex interplay of pro- and
Publishing remains neutral with anti-inflammatory responses, leading to multiorgan dysfunction. Due to the broad
1
regard to jurisdictional claims in
published maps and institutional spectrum of pathophysiological causes and clinical manifestations, intensivists face
affiliations. challenges pinpointing specific medications for sepsis. Current sepsis treatments mainly
Volume 2 Issue 1 (2025) 3 doi: 10.36922/mi.4742