肺腸軸失調在膿毒癥相關急性呼吸窘迫綜合征中的病理機制及治療策略研究進展_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

裴斯彤 ¹ , 何繼星 ¹ , 李承方 ¹ , 路佩源 ¹ ,  袁媛 ²

1. ;
2. ;

Corresponding?author：

袁媛, Email: lanzhouyy@163.com

Keywords：

DOI：

10.7507/1671-6205.202508074

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Citation： 裴斯彤, 何繼星, 李承方, 路佩源, 袁媛. 肺腸軸失調在膿毒癥相關急性呼吸窘迫綜合征中的病理機制及治療策略研究進展. Chinese Journal of Respiratory and Critical Care Medicine, 2026, 25(5): 381-384. doi: 10.7507/1671-6205.202508074 Copy

1.	Wang Y, Zhang L, Xi X, et al; China Critical Care Sepsis Trial (CCCST) Workgroup. The association between etiologies and mortality in acute respiratory distress syndrome: a multicenter observational cohort study. Front Med (Lausanne), 2021, 8: 739596.
2.	Zhang J, Yan W, Dong Y, et al. Early identification and diagnosis, pathophysiology, and treatment of sepsis-related acute lung injury: a narrative review. J Thorac Dis, 2024, 16(8): 5457-5476.
3.	Charoensappakit A, Sae-Khow K, Maneesow P, et al. Predictive efficacy of plasma arginase 1 as a novel biomarker for mechanical ventilated patients with sepsis induced acute respiratory distress syndrome: a prospective cohort study. Respir Med, 2025, 246: 108227.
4.	Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med, 2013, 369(9): 840-851.
5.	Fonseca W, Lucey K, Jang S, et al. Lactobacillus johnsonii supplementation attenuates respiratory viral infection via metabolic reprogramming and immune cell modulation. Mucosal Immunol, 2017, 10(6): 1569-1580.
6.	Trompette A, Gollwitzer ES, Yadava K, et al. Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis. Nat Med, 2014, 20(2): 159-166.
7.	Budden KF, Gellatly SL, Wood DL, et al. Emerging pathogenic links between microbiota and the gut-lung axis. Nat Rev Microbiol, 2017, 15(1): 55-63.
8.	Stavropoulou E, Kantartzi K, Tsigalou C, et al. Unraveling the interconnection patterns across lung microbiome, respiratory diseases, and COVID-19. Front Cell Infect Microbiol, 2021, 10: 619075.
9.	Clark JA, Coopersmith CM. Intestinal crosstalk: a new paradigm for understanding the gut as the "motor" of critical illness. Shock, 2007, 28(4): 384-393.
10.	Klingensmith NJ, Coopersmith CM. The gut as the motor of multiple organ dysfunction in critical illness. Crit Care Clin, 2016, 32(2): 203-12.
11.	Shu T, Zhang J, Hu R, et al. Qi Huang Fang improves intestinal barrier function and intestinal microbes in septic mice through NLRP3 inflammasome-mediated cellular pyroptosis. Transpl Immunol, 2024, 85: 102072.
12.	Xie B, Wang M, Zhang X, et al. Gut-derived memory γδ T17 cells exacerbate sepsis-induced acute lung injury in mice. Nat Commun, 2024, 15(1): 6737.
13.	邱小晶, 白雪, 張有為, 等. 腸道菌群與急性肺損傷關系的研究進展. 中國微生態學雜志, 2025, 37(2): 233-239.
14.	Dickson RP. The microbiome and critical illness. Lancet Respir Med, 2016, 4(1): 59-72.
15.	Dickson RP, Singer BH, Newstead MW, et al. Enrichment of the lung microbiome with gut bacteria in sepsis and the acute respiratory distress syndrome. Nat Microbiol, 2016, 1(10): 16113.
16.	Feng Y, Wang Y, Wang P, et al. Short-chain fatty acids manifest stimulative and protective effects on intestinal barrier function through the inhibition of NLRP3 inflammasome and autophagy. Cell Physiol Biochem, 2018, 49(1): 190-205.
17.	Ren Z, Zheng Z, Feng X. Role of gut microbes in acute lung injury/acute respiratory distress syndrome. Gut Microbes, 2024, 16(1): 2440125.
18.	Zhang DW, Lu JL, Dong BY, et al. Gut microbiota and its metabolic products in acute respiratory distress syndrome. Front Immunol, 2024, 15: 1330021.
19.	Shi X, Zhu L, Wang S, et al. Magnesium hydride ameliorates endotoxin-induced acute respiratory distress syndrome by inhibiting inflammation, oxidative stress, and cell apoptosis. Oxid Med Cell Longev, 2022, 2022: 5918954.
20.	Ju Y, Qiu L, Sun X, et al. Ac2-26 mitigated acute respiratory distress syndrome rats via formyl peptide receptor pathway. Ann Med, 2021, 53(1): 653-661.
21.	Xu B, Zhang L, Wu D, et al. CuO nanoparticles elicit intestinal immunotoxicity in zebrafish based on intestinal microbiota dysbiosis. Food Funct, 2024, 15(14): 7619-7630.
22.	Wang YH, Yan ZZ, Luo SD, et al. Gut microbiota-derived succinate aggravates acute lung injury after intestinal ischaemia/reperfusion in mice. Eur Respir J, 2023, 61(2): 2200840.
23.	Chen ML, Zhu XH, Ran L, et al. Trimethylamine-n-oxide induces vascular inflammation by activating the NLRP3 inflammasome through the SIRT3-SOD2-mtROS signaling pathway. J Am Heart Assoc, 2017, 6(9): e006347.
24.	Xie B, Zhang Y, Han M, et al. Reversal of the detrimental effects of social isolation on ischemic cerebral injury and stroke-associated pneumonia by inhibiting small intestinal γδ T-cell migration into the brain and lung. J Cereb Blood Flow Metab, 2023, 43(8): 1267-1284.
25.	He Z, Wang Z, Yin J, et al. Research progress on microecology and childhood respiratory infections via the lung-gut axis. Front Pediatr, 2025, 13: 1509333.
26.	Tang Y, Chen L, Yang J, et al. Gut microbes improve prognosis of Klebsiella pneumoniae pulmonary infection through the lung-gut axis. Front Cell Infect Microbiol, 2024, 14: 1392376.
27.	段乃凡, 余圓圓, 何玉蓉, 等. 基于“肺-腸軸”探討痰熱清膠囊對流感病毒感染小鼠的肺腸保護作用. 中國中藥雜志, 2025, 50(8): 2270-2281.
28.	Zhang Y, Wan Y, Xin X, et al. Signals from intestinal microbiota mediate the crosstalk between the lung-gut axis in an influenza infection mouse model. Front Immunol, 2024, 15: 1435180.
29.	Li Y, Jiao J, Qiao H, et al. Aromatic molecular compatibility attenuates influenza virus-induced acute lung injury via the lung-gut axis and lipid droplet modulation. Pharmaceuticals (Basel), 2025, 18(4): 468.
30.	Wong CK, McLean BA, Baggio LL, et al. Central glucagon-like peptide 1 receptor activation inhibits Toll-like receptor agonist-induced inflammation. Cell Metab, 2024, 36(1): 130-143,e5.
31.	Jogani VG, Mohamed Elfadil O, Edakkanambeth Varayil J, et al. Exploring the role of glucagon-like peptide-1 receptor agonists in critical illness: mechanisms, benefits, and clinical implications. Curr Opin Crit Care, 2025, 31(4): 370-378.
32.	Weng J, Wang X, Lin J, et al. Identifying potential drug targets for sepsis-related adult respiratory distress syndrome through comprehensive genetic analysis and druggability assessment. J Glob Health, 2025, 15: 04117.
33.	Ma PJ, Wang MM, Wang Y. Gut microbiota: a new insight into lung diseases. Biomed Pharmacother, 2022, 155: 113810.
34.	Zhuang C, Kang M, Lee M. Delivery systems of therapeutic nucleic acids for the treatment of acute lung injury/acute respiratory distress syndrome. J Control Release, 2023, 360: 1-14.

1. Wang Y, Zhang L, Xi X, et al; China Critical Care Sepsis Trial (CCCST) Workgroup. The association between etiologies and mortality in acute respiratory distress syndrome: a multicenter observational cohort study. Front Med (Lausanne), 2021, 8: 739596.
2. Zhang J, Yan W, Dong Y, et al. Early identification and diagnosis, pathophysiology, and treatment of sepsis-related acute lung injury: a narrative review. J Thorac Dis, 2024, 16(8): 5457-5476.
3. Charoensappakit A, Sae-Khow K, Maneesow P, et al. Predictive efficacy of plasma arginase 1 as a novel biomarker for mechanical ventilated patients with sepsis induced acute respiratory distress syndrome: a prospective cohort study. Respir Med, 2025, 246: 108227.
4. Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med, 2013, 369(9): 840-851.
5. Fonseca W, Lucey K, Jang S, et al. Lactobacillus johnsonii supplementation attenuates respiratory viral infection via metabolic reprogramming and immune cell modulation. Mucosal Immunol, 2017, 10(6): 1569-1580.
6. Trompette A, Gollwitzer ES, Yadava K, et al. Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis. Nat Med, 2014, 20(2): 159-166.
7. Budden KF, Gellatly SL, Wood DL, et al. Emerging pathogenic links between microbiota and the gut-lung axis. Nat Rev Microbiol, 2017, 15(1): 55-63.
8. Stavropoulou E, Kantartzi K, Tsigalou C, et al. Unraveling the interconnection patterns across lung microbiome, respiratory diseases, and COVID-19. Front Cell Infect Microbiol, 2021, 10: 619075.
9. Clark JA, Coopersmith CM. Intestinal crosstalk: a new paradigm for understanding the gut as the "motor" of critical illness. Shock, 2007, 28(4): 384-393.
10. Klingensmith NJ, Coopersmith CM. The gut as the motor of multiple organ dysfunction in critical illness. Crit Care Clin, 2016, 32(2): 203-12.
11. Shu T, Zhang J, Hu R, et al. Qi Huang Fang improves intestinal barrier function and intestinal microbes in septic mice through NLRP3 inflammasome-mediated cellular pyroptosis. Transpl Immunol, 2024, 85: 102072.
12. Xie B, Wang M, Zhang X, et al. Gut-derived memory γδ T17 cells exacerbate sepsis-induced acute lung injury in mice. Nat Commun, 2024, 15(1): 6737.
13. 邱小晶, 白雪, 張有為, 等. 腸道菌群與急性肺損傷關系的研究進展. 中國微生態學雜志, 2025, 37(2): 233-239.
14. Dickson RP. The microbiome and critical illness. Lancet Respir Med, 2016, 4(1): 59-72.
15. Dickson RP, Singer BH, Newstead MW, et al. Enrichment of the lung microbiome with gut bacteria in sepsis and the acute respiratory distress syndrome. Nat Microbiol, 2016, 1(10): 16113.
16. Feng Y, Wang Y, Wang P, et al. Short-chain fatty acids manifest stimulative and protective effects on intestinal barrier function through the inhibition of NLRP3 inflammasome and autophagy. Cell Physiol Biochem, 2018, 49(1): 190-205.
17. Ren Z, Zheng Z, Feng X. Role of gut microbes in acute lung injury/acute respiratory distress syndrome. Gut Microbes, 2024, 16(1): 2440125.
18. Zhang DW, Lu JL, Dong BY, et al. Gut microbiota and its metabolic products in acute respiratory distress syndrome. Front Immunol, 2024, 15: 1330021.
19. Shi X, Zhu L, Wang S, et al. Magnesium hydride ameliorates endotoxin-induced acute respiratory distress syndrome by inhibiting inflammation, oxidative stress, and cell apoptosis. Oxid Med Cell Longev, 2022, 2022: 5918954.
20. Ju Y, Qiu L, Sun X, et al. Ac2-26 mitigated acute respiratory distress syndrome rats via formyl peptide receptor pathway. Ann Med, 2021, 53(1): 653-661.
21. Xu B, Zhang L, Wu D, et al. CuO nanoparticles elicit intestinal immunotoxicity in zebrafish based on intestinal microbiota dysbiosis. Food Funct, 2024, 15(14): 7619-7630.
22. Wang YH, Yan ZZ, Luo SD, et al. Gut microbiota-derived succinate aggravates acute lung injury after intestinal ischaemia/reperfusion in mice. Eur Respir J, 2023, 61(2): 2200840.
23. Chen ML, Zhu XH, Ran L, et al. Trimethylamine-n-oxide induces vascular inflammation by activating the NLRP3 inflammasome through the SIRT3-SOD2-mtROS signaling pathway. J Am Heart Assoc, 2017, 6(9): e006347.
24. Xie B, Zhang Y, Han M, et al. Reversal of the detrimental effects of social isolation on ischemic cerebral injury and stroke-associated pneumonia by inhibiting small intestinal γδ T-cell migration into the brain and lung. J Cereb Blood Flow Metab, 2023, 43(8): 1267-1284.
25. He Z, Wang Z, Yin J, et al. Research progress on microecology and childhood respiratory infections via the lung-gut axis. Front Pediatr, 2025, 13: 1509333.
26. Tang Y, Chen L, Yang J, et al. Gut microbes improve prognosis of Klebsiella pneumoniae pulmonary infection through the lung-gut axis. Front Cell Infect Microbiol, 2024, 14: 1392376.
27. 段乃凡, 余圓圓, 何玉蓉, 等. 基于“肺-腸軸”探討痰熱清膠囊對流感病毒感染小鼠的肺腸保護作用. 中國中藥雜志, 2025, 50(8): 2270-2281.
28. Zhang Y, Wan Y, Xin X, et al. Signals from intestinal microbiota mediate the crosstalk between the lung-gut axis in an influenza infection mouse model. Front Immunol, 2024, 15: 1435180.
29. Li Y, Jiao J, Qiao H, et al. Aromatic molecular compatibility attenuates influenza virus-induced acute lung injury via the lung-gut axis and lipid droplet modulation. Pharmaceuticals (Basel), 2025, 18(4): 468.
30. Wong CK, McLean BA, Baggio LL, et al. Central glucagon-like peptide 1 receptor activation inhibits Toll-like receptor agonist-induced inflammation. Cell Metab, 2024, 36(1): 130-143,e5.
31. Jogani VG, Mohamed Elfadil O, Edakkanambeth Varayil J, et al. Exploring the role of glucagon-like peptide-1 receptor agonists in critical illness: mechanisms, benefits, and clinical implications. Curr Opin Crit Care, 2025, 31(4): 370-378.
32. Weng J, Wang X, Lin J, et al. Identifying potential drug targets for sepsis-related adult respiratory distress syndrome through comprehensive genetic analysis and druggability assessment. J Glob Health, 2025, 15: 04117.
33. Ma PJ, Wang MM, Wang Y. Gut microbiota: a new insight into lung diseases. Biomed Pharmacother, 2022, 155: 113810.
34. Zhuang C, Kang M, Lee M. Delivery systems of therapeutic nucleic acids for the treatment of acute lung injury/acute respiratory distress syndrome. J Control Release, 2023, 360: 1-14.

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肺腸軸失調在膿毒癥相關急性呼吸窘迫綜合征中的病理機制及治療策略研究進展

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