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Published on: February 17, 2023
Mapping the evolution of sepsis and intestinal epithelial barrier research: a bibliometric analysis (1977-2024)
1Department of Intensive Care Unit, Baoshan Branch of Huashan Hospital Affiliated to Fudan University, Shanghai, China.
Background:
Sepsis remains a leading cause of mortality worldwide. Although sepsis most commonly originates from non-abdominal infections, intestinal epithelial barrier dysfunction has been increasingly investigated as a relevant contributor in a subset of patients and as a potential amplifier of systemic inflammation. This study aimed to map research trends at the intersection of sepsis and the intestinal epithelial barrier using bibliometric methods.
Methods:
A comprehensive literature search was conducted on the Web of Science Core Collection (WoSCC) on November 14, 2024. VOSviewer (version 1.6.20), CiteSpace (version 6.3.R1), and R 4.3.3 were used to carry out the bibliometric workflow and produce visualization results.
Results:
A total of 1,231 articles published between 1977 and 2024 were included, involving 7,495 authors from 3,963 institutions across 401 countries/regions. The USA contributed the largest number of corresponding-author publications (n=321) and had the highest total citations (TC =20,103). The University of California System contributed the highest number of publications (n=73). Cani Patrice D. was the most influential author by H-index (H-index =12) and total citations (TC =13,869). The journal Shock ranked first by H-index (H-index =24), with 42 publications and 750 citations. Keyword co-occurrence analysis identified three clusters: sepsis physiology and complications; microbiota-metabolic endotoxemia; and molecular barrier dysfunction. "Intestinal permeability" was the most frequent keyword (240 occurrences), while "endotoxemia" had the strongest total link strength [860]. Burst detection showed recent increases in terms such as "gut microbiota" [2018-2024] and "tight junction" [2020-2024].
Conclusions:
The literature linking sepsis and the intestinal epithelial barrier has expanded and diversified over time. Recent research emphasizes microbiota-immune-metabolic interactions and barrier-focused mechanisms and interventions, which may be particularly pertinent to abdominal sepsis and to systemic inflammatory amplification rather than to all sepsis etiologies. Future studies are expected to further integrate microbiology, immunology, metabolism, and translational therapeutics to clarify which patient subgroups may benefit from barrier-targeted strategies.
