Clinical Report: The Role of the Gastrointestinal System in Post-Traumatic Sepsis

Overview

This review discusses the evolving understanding of the gastrointestinal system's role in post-traumatic sepsis, introducing the concept of the Gastrointestinal Axis (GIA) and highlighting potential therapeutic targets such as gastric autophagy and early enteral nutrition.

Background

Post-traumatic sepsis is a leading cause of late mortality in intensive care units. The gastrointestinal tract, particularly the stomach, has been increasingly recognized as an active participant in the pathogenesis of sepsis. Understanding the mechanisms underlying gastrointestinal dysfunction may provide new avenues for prevention and treatment.

Data Highlights

This review synthesizes findings from various studies on gut barrier dysfunction, dysbiosis, autophagy, and immune responses in post-traumatic sepsis.

Key Findings

• The concept of the Gastrointestinal Axis (GIA) integrates gastric and intestinal dysfunction as drivers of post-traumatic sepsis.
• Histone deacetylase 5 (HDAC5) upregulation silences ghrelin, impairing gastric autophagy and intestinal barrier integrity.
• Emerging biomarkers such as intestinal fatty acid-binding protein and D-lactate enable multimodal risk stratification in post-traumatic sepsis.
• Early enteral nutrition and synbiotics show promise in reducing the risk of post-traumatic sepsis.
• Preclinical data support the potential of HDAC5 inhibitors and ghrelin restoration as adjunct therapies.

Clinical Implications

Addressing gastric dysfunction may be crucial in preventing post-traumatic sepsis.

Conclusion

The review highlights the importance of the gastrointestinal system in post-traumatic sepsis.

Related Resources & Content

1. Frontiers in Immunology, 2026 -- Gut barrier-microbiota crosstalk in sepsis: from pathogenesis to potential therapies
2. Frontiers in Medicine, 2026 -- The high-risk phenotype for gastrointestinal vulnerability in sepsis and 28-day mortality: an integrative study based on clinical association and cross-level biological support
3. Critical Care (Springer), 2025 -- Rethinking post-sepsis syndrome: linking cellular dysfunction to the clinical picture
4. Surviving Sepsis Campaign Adult Guidelines | SCCM
5. Influence of early enteral nutrition on mortality of adult patients with sepsis: a meta-analysis of randomized controlled trials - PubMed
6. Critical Care (Springer) — Intestinal lactate as a crucial molecular for intestinal epithelial cell renewal in sepsis
7. Surviving Sepsis Campaign Adult Guidelines | SCCM
8. Influence of early enteral nutrition on mortality of adult patients with sepsis: a meta-analysis of randomized controlled trials - PubMed
9. A review of gut failure as a cause and consequence of critical illness