, Volume 56, Issue 8, pp 2212-2214
Date: 23 Apr 2011

Dangerous Disappearing Act: Commensal Gut Microbiota After Acute Severe Insults

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The trillions of cells that make up the human gut microbiota are a double-edged sword, often protecting the host from serious infection, but capable of causing lethal inflammation and overwhelming sepsis. This Janus-faced characteristic of the gut microbiota resembles the immune system itself, a powerful defense that can turn on its host. Altered gut microflora is involved in the pathogenesis of a wide variety of diseases, including metabolic syndrome, obesity, congestive heart failure, pancreatitis, inflammatory bowel disease, and critical illness [14]. As Hayakawa et al. point out in this issue of Digestive Diseases and Sciences, the gut microbiota is also dramatically changed in acute trauma, out-of-hospital cardiac arrest, and cerebrovascular disease [5]. These authors document the sudden disappearance of commensal bacteria after acute severe insults, raising the question, why?

Most studies of gut microbiota in critical illness have examined hospitalized patients receiving intensiv ...