实用医学杂志 ›› 2025, Vol. 41 ›› Issue (13): 2105-2110.doi: 10.3969/j.issn.1006-5725.2025.13.024

• 综述 • 上一篇    

短链脂肪酸多靶点调控脓毒症器官保护的研究进展

田云芬1,王斌2,章放香2()   

  1. 1.贵州医科大学麻醉学院 (贵州 贵阳 550001 )
    2.贵州医科大学附属人民医院麻醉科 (贵州 贵阳 550002 )
  • 收稿日期:2025-03-17 出版日期:2025-07-10 发布日期:2025-07-18
  • 通讯作者: 章放香 E-mail:zfx1205@126.com
  • 基金资助:
    国家自然科学基金项目(82260376)

Multi-target regulation of short-chain fatty acids in sepsis

Yunfen TIAN1,Bin WANG2,Fangxiang ZHANG2()   

  1. Institute of Anesthesiology,Guizhou Medical University,Guiyang 550002,Guizhou,China
  • Received:2025-03-17 Online:2025-07-10 Published:2025-07-18
  • Contact: Fangxiang ZHANG E-mail:zfx1205@126.com

摘要:

脓毒症作为感染引发的全身性炎症反应失调性疾病,其复杂的病理生理机制导致高病死率与治疗瓶颈。作为肠道菌群的核心代谢产物,短链脂肪酸(short-chain fatty acids, SCFAs)通过多靶点调控机制在脓毒症器官保护中展现出潜力。在免疫调节方面,SCFAs通过激活G蛋白偶联受体和抑制NLRP3炎症小体活化及促炎因子级联反应,平衡促炎与抗炎反应。在代谢调控层面,SCFAs优化线粒体功能并缓解脓毒症相关高分解代谢状态,减轻器官能量衰竭。此外,SCFAs通过增强肠道屏障完整性、抑制病原体易位,并通过肠-器官轴协同机制改善全身炎症扩散,多途径发挥器官保护作用。动物及临床前研究表明,外源性SCFAs补充或膳食纤维干预或可协同肠道菌群,为脓毒症治疗提供新策略。本文系统梳理SCFAs在脓毒症中的多靶点调控网络及其在脓毒症器官保护中的研究进展,提出靶向菌群代谢产物的治疗策略,为突破传统抗感染与免疫调节的局限提供新视角。

关键词: 脓毒症, 短链脂肪酸, 肠道菌群, 肠-器官轴

Abstract:

Sepsis, a systemic inflammatory disorder triggered by infection, is characterized by a complex pathophysiological mechanism that gives rise to high mortality rates and treatment bottlenecks. Short-Chain Fatty Acids (SCFAs), as the core metabolites of the intestinal flora, exhibit potential in organ protection during sepsis via a multi-target regulatory mechanism. In the realm of immunomodulation, SCFAs achieve a balance between pro-inflammatory and anti-inflammatory responses by activating G protein-coupled receptors, inhibiting the activation of NLRP3 inflammasomes, and suppressing the cascade reaction of pro-inflammatory factors. At the metabolic regulation level, SCFAs optimize mitochondrial function, mitigate the hypercatabolic state associated with sepsis, and relieve organ energy failure. Furthermore, SCFAs exert an organ-protective effect in multiple ways. They enhance the integrity of the intestinal barrier, inhibit pathogen translocation, and impede the systemic spread of inflammation through the synergistic mechanisms of the intestinal-organ axis. Animal and preclinical studies have demonstrated that exogenous supplementation of SCFAs or dietary fiber intervention may interact with the intestinal flora, offering a novel strategy for sepsis treatment. In this review, we systematically summarize the multi-target regulatory network of SCFAs in sepsis and the research progress regarding their organ-protective effects in sepsis. Additionally, we propose therapeutic strategies targeting microbial metabolites, thereby providing a new perspective for overcoming the limitations of traditional anti-infection and immunomodulation.

Key words: sepsis, short-chain fatty acids, gut microbiota, intestine-organ axis

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