IMR Press / FBL / Volume 11 / Issue 1 / DOI: 10.2741/1816

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Article
Role of the gut in the development of injury- and shock induced SIRS and MODS: the gut-lymph hypothesis, a review
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1 Department of Surgery, UMDNJ-New Jersey Medical School, MSB G506, 185 South Orange Avenue, Newark, New Jersey 07103
Academic Editor:Avadhesh Sharma
Front. Biosci. (Landmark Ed) 2006, 11(1), 520–528; https://doi.org/10.2741/1816
Published: 1 January 2006
(This article belongs to the Special Issue Advances in systemic inflammatory response)
Abstract

It has long been recognized that major trauma, shock, or burn injury can lead to an acute systemic inflammatory state (SIRS) as well as the multiple organ dysfunction syndrome (MODS). Because of the high mortality rate associated with the development of MODS, for over two decades an intense effort has been devoted towards trying to unravel the underlying mechanisms of this complex syndrome. Although the gut has been implicated in the development of SIRS and MODS experimentally and clinically, its exact role in the pathogenesis of SIRS and MODS remains controversial. However, based on recent experimental evidence, it appears that unique gut-derived factors carried in the intestinal lymph, but not the portal vein, lead to acute injury- and shock-induced SIRS and MODS. These observations have led to the gut-lymph hypothesis of MODS, where gut-derived factors present in intestinal (mesenteric) lymph serve as the triggers that initiate the systemic inflammatory and tissue injurious responses observed after major trauma or episodes of shock.

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