Gut Leakage of Fungal-Derived Inflammatory Mediators: Part of a Gut-Liver-Kidney Axis in Bacterial Sepsis

  • Panomwat Amornphimoltham
  • Peter S. T. Yuen
  • Robert A. Star
  • Asada LeelahavanichkulEmail author


Sepsis is a life-threatening response to systemic infection. In addition to frank gastrointestinal (GI) rupture/puncture, sepsis can also be exacerbated by translocation of pathogen-associated molecular patterns (PAMPs) from the GI tract to the systemic circulation (gut origin of sepsis). In the human gut, Gram-negative bacteria and Candida albicans are abundant, along with their major PAMP components, endotoxin (LPS) and (1 → 3)-β-d-glucan (BG). Whereas the influence of LPS in bacterial sepsis has been studied extensively, exploration of the role of BG in bacterial sepsis is limited. Post-translocation, PAMPs enter the circulation through lymphatics and the portal vein, and are detoxified and then excreted via the liver and the kidney. Sepsis-induced liver and kidney injury might therefore affect the kinetics and increase circulating PAMPs. In this article, we discuss the current knowledge of the impact of PAMPs from both gut mycobiota and microbiota, including epithelial barrier function and the “gut-liver-kidney axis,” on bacterial sepsis severity.


Gut leakage Sepsis (1 → 3)-β-d-glucan Endotoxin Renal failure 



Chulalongkorn University Office of International Affairs Scholarship for Short-term Research and Ratchadapisek Somphot Fund for Postdoctoral Fellowship, Chulalongkorn University.

Compliance with ethical standards

Conflict of interest



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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Panomwat Amornphimoltham
    • 1
  • Peter S. T. Yuen
    • 2
  • Robert A. Star
    • 2
  • Asada Leelahavanichkul
    • 1
    • 3
    Email author
  1. 1.Immunology Unit, Department of MicrobiologyChulalongkorn UniversityBangkokThailand
  2. 2.Renal Diagnostics and Therapeutics Unit, National Institute of Diabetes and Digestive and Kidney DiseasesNational Institutes of HealthBethesdaUSA
  3. 3.Center of Excellence in Immunology and Immune-mediated Diseases, Department of MicrobiologyChulalongkorn UniversityBangkokThailand

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