[Homeostasis of small molecules originating from microbes and its role in microbial relations with the host]

It is suggested that disorders at the low molecular levels--at the level of small molecules originating from microbes (SMOM) underlie nonspecific pyoinflammatory diseases and decompensation of SMOM homeostatic disorders in the human blood plays a certain role in the complex multifactorial pathogenesis of sepsis. The blood from 16 donors showed fatty acids (hydroxy acids, branched, short-chain, unsaturated, cyclopropanic acids), aldehydes, alcohols, and phenylcarbolic compounds which are not produced by mammalian cells and which are structural components or microbial metabolites. That from 59 patients with various diseases (peritonitis, endocarditis, urinary tract infection, etc.) displayed a reduction or a complete disappearance of only small molecules which are as part of the endogenous microflora and, concomitantly, a 100-fold increase or more in other molecules, and the emergence of new SMOM lacking in the donor blood. The findings yield a concept that there is the homeostasis of small molecules originating from microbes, whose severe disorders (SMOM homeostatic decompensation) are likely to be a first link in the genesis of a systemic inflammatory response, in the development of septic shock and multiorgan failure.