The innervated gut and critical illness
Jacob W Larsson1,2, Peder S Olofsson2,3, Eva Sundman1,2
1Function Perioperative Medicine and Intensive Care, Karolinska University Hospital.
Current Opinion in Critical Care
|March 6, 2025
Summary
Brain-gut neuroimmune interactions are crucial in critical illness, regulating inflammation and gut homeostasis. Further research into these pathways may reveal novel therapeutic targets for critically ill patients.
Area of Science:
- Neuroscience
- Immunology
- Gastroenterology
Background:
- Critical illness involves complex organ dysfunction, particularly affecting the gastrointestinal system.
- Neuroimmune interactions play a significant role in regulating inflammation and maintaining homeostasis.
Purpose of the Study:
- To review brain-gut neuroimmune interactions in critical illness.
- To discuss neural regulation of inflammation, gut innervation, and the brain-gut axis.
Main Methods:
- Literature review of recent studies on brain-gut axis and neuroimmune pathways.
- Analysis of experimental evidence regarding neural control of immune responses and gastrointestinal homeostasis.
Main Results:
- The brain-gut axis and enteric nervous system are integral to inflammation regulation.
- Neural reflexes control immune responses and promote gastrointestinal homeostasis.
- Therapeutic interventions targeting neuro-immune pathways show promise in preclinical models.
Conclusions:
- Neuroimmune interactions between the gut, immune cells, nerves, and CNS regulate inflammation in critical illness.
- Clinical validation of neural reflexes in critical care is lacking.
- Future research should explore harnessing neuro-immune crosstalk for gastrointestinal support in critically ill patients.
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