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[Pathogenesis of pancreatogenic sepsis]
1Chirurgische Klinik I, Universitätsklinikum Benjamin Franklin, Berlin.
Abstract:
The intestinal tract is the motor of sepsis in the "gut-MOF hypothesis". Acute pancreatitis causes an early severe reduction of intestinal microcirculation with consequent production of radicals and cytokines damaging intestinal integrity. The intestinal organ dysfunction syndrome results in a breakdown of barrier function and a loss of propulsive activity. This leads to microbial overgrowth and bacterial translocation. This liberates cytokines and causes secondary pancreatic infection after lymphatic and systemic bacterial dissemination. Infected pancreatic necrosis by enteric microorganisms is the main cause of pancreatic sepsis.
Insights
Acute pancreatitis severely impairs intestinal microcirculation, leading to gut barrier dysfunction and bacterial translocation. This process drives sepsis development and secondary pancreatic infections, highlighting the gut
Area of Science:
- Gastroenterology and immunology
- Pathophysiology of sepsis
Context:
- Sepsis pathogenesis is complex, involving multiple organ systems.
- The gut-intestinal tract plays a critical role in the development of sepsis, as described by the 'gut-MOF hypothesis'.
- Acute pancreatitis is a condition that can trigger systemic inflammatory responses and organ dysfunction.
Purpose:
- To elucidate the role of the intestinal tract in the development of sepsis following acute pancreatitis.
- To explain the mechanisms by which pancreatic injury leads to gut dysfunction and subsequent sepsis.
Summary:
- Acute pancreatitis causes reduced intestinal microcirculation, leading to oxidative stress and cytokine release, which damages intestinal integrity.
- This intestinal organ dysfunction syndrome results in a loss of barrier function and impaired motility, promoting microbial overgrowth and bacterial translocation.
- Bacterial translocation from the gut liberates cytokines and facilitates secondary pancreatic infection, ultimately causing pancreatic sepsis due to enteric microorganisms.
Impact:
- Understanding the gut-intestinal tract's role in sepsis can lead to novel therapeutic strategies targeting gut integrity.
- This research highlights the importance of early intervention in acute pancreatitis to prevent gut-derived sepsis.
- The findings contribute to the understanding of multi-organ failure (MOF) in sepsis, emphasizing the gut as a central player.