• Ashley A Miniet, Jocelyn R Grunwell, and Craig M Coopersmith.
• Division of Critical Care Medicine, Department of Pediatrics, Emory University School of Medicine.
• Curr Opin Crit Care. 2021 Apr 1; 27 (2): 157163157-163.

Purpose Of ReviewAlthough the gut microbiome plays a crucial role in the maintenance of health, it is hypothesized to drive morbidity and mortality in critically ill patients. This review describes the relationship between the gut microbiome and the immune system in critical illness.Recent FindingsThe gut microbiome is converted to a pathobiome in the ICU, characterized by decreased microbial diversity and pathogen predominance. These changes are induced by a pathologic microenvironment and are further exacerbated by common medical treatments initiated in the ICU. The conversion of the microbiome to a pathobiome has direct consequences on the regulation of inflammation and immunity by loss of beneficial host responses and initiation of maladaptive changes that can further propagate critical illness.SummaryThe gut microbiome is dramatically altered in the ICU. In light of constant crosstalk between the microbiome and the host immune system, the pathobiome may play a key mechanistic role in driving a maladaptive response in critically ill patients. The pathobiome represents a potential therapeutic target in the management of critical illness whereby restoration of a healthier microbiome may directly alter the host inflammatory response, which could lead to improved patient outcomes.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

5 keywords...

hide…