Latorre M, Krishnareddy S, Freedberg DE. Microbiome as mediator: Do systemic infections start in the gut? World J Gastroenterol 2015; 21(37): 10487-10492 [PMID: 26457009 DOI: 10.3748/wjg.v21.i37.10487]
Corresponding Author of This Article
Daniel E Freedberg, MD, Assistant Professor of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, PH7, New York, NY 10023, United States. def2004@cumc.columbia.edu
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Oct 7, 2015; 21(37): 10487-10492 Published online Oct 7, 2015. doi: 10.3748/wjg.v21.i37.10487
Microbiome as mediator: Do systemic infections start in the gut?
Melissa Latorre, Suneeta Krishnareddy, Daniel E Freedberg
Melissa Latorre, Suneeta Krishnareddy, Daniel E Freedberg, Division of Digestive and Liver Diseases, Columbia University Medical Center, New York, NY 10023, United States
Author contributions: Latorre M, Krishnareddy S and Freedberg DE all contributed to this paper.
Supported by Mentored Career Development Award through the National Center for Advancing Translational Sciences’ Clinical and Translational Science Awards program, No. NIH KL2 TR000081 (in part).
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported. Dr. Freedberg was supported in part by a mentored career development award through the National Center for Advancing Translational Sciences’ Clinical and Translational Science Awards program (NIH KL2 TR000081).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Daniel E Freedberg, MD, Assistant Professor of Medicine, Division of Digestive and Liver Diseases, Columbia University Medical Center, 630 West 168th Street, PH7, New York, NY 10023, United States. def2004@cumc.columbia.edu
Telephone: +1-212-3053427
Received: January 29, 2015 Peer-review started: January 30, 2015 First decision: April 14, 2015 Revised: April 28, 2015 Accepted: August 31, 2015 Article in press: August 31, 2015 Published online: October 7, 2015 Processing time: 242 Days and 4.4 Hours
Abstract
The intestinal microbiome is emerging as a crucial mediator between external insults and systemic infections. New research suggests that our intestinal microorganisms contribute to critical illness and the development of non-gastrointestinal infectious diseases. Common pathways include a loss of fecal intestinal bacterial diversity and a disproportionate increase in toxogenic bacterial species. Therapeutic interventions targeting the microbiome - primarily probiotics - have yielded limited results to date. However, knowledge in this area is rapidly expanding and microbiome-based therapy such as short-chain fatty acids may eventually become a standard strategy for preventing systemic infections in the context of critical illness.
Core tip: The role of the intestinal microbiome in the development and treatment of Clostridium difficile (C. difficile) infection is well established. However, the intestinal microbiome is emerging as a crucial mediator in the development of systemic disease and non-gastrointestinal infection. If the pathways linking gut bacteria to systemic infections can be elucidated, it may become possible to intervene upon the microbiome before disease occurs. This understanding would move clinicians beyond fecal microbial transplant for C. difficile infection to paradigm-changing treatments for gut-derived systemic infections.
