The gut as a potential trigger of exercise-induced inflammatory responses
The gut as a potential trigger of exercise-induced inflammatory responses
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DOI：
10.1139/cjpp-76-5-479
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发表时间：
1998-05-01
影响因子：
2.1
通讯作者：
Marshall, JC
中科院分区：
文献类型：
--
作者：
Marshall, JC
多种证据支持这一假设，即缺血引起的正常肠道屏障功能损伤，以及肠道免疫系统正常补益抗炎作用的丧失，有助于在创伤和压倒性感染的危重患者中表达不受控制的炎症。临床综合征被称为全身性炎症反应综合征（SIRS），它体现了创伤和败血症中不受控制的炎症，在剧烈运动中完全重现，这提高了肠道在运动诱导炎症中发挥作用的可能性。剧烈运动和全身性败血症都会导致正常肠道屏障对肠道微生物的损害，并导致细菌内毒素循环水平升高。在正常情况下，肠-肝轴的免疫组织抑制宿主对肠道内食物或肠壁本地微生物菌群的反应表达。这种影响是一个积极的，需要能量的过程。剧烈运动和危重疾病都与肠道缺血有关，这为启动失调的炎症反应提供了共同的生物学基础。尽管支持或反驳肠道可以在剧烈运动后引发全身性炎症这一假设的直接证据很少，但SIRS和运动在临床表现上的相似之处，以及在危重疾病中预防或治疗肠道导向策略的有希望的结果，表明类似的方法可能对从事极端体育锻炼的个体有益。
Multiple lines of evidence support the hypothesis that ischemia-induced impairment of normal gut barrier function, with loss of the normal tonic counterinflammarory influence of the gut immune system, contributes to the expression of uncontrolled inflammation in critically ill victims of trauma and overwhelming infection. The clinical syndrome known as the systemic inflammatory response syndrome (SIRS), which embodies uncontrolled inflammation in trauma and sepsis, is reproduced in its entirety by vigourous exercise, raising the possibility that the gut may also play a role in exercise-induced inflammation. Both strenuous exercise and systemic sepsis result in impairment of the normal gut barrier to luminal microorganisms, and result in elevated circulating levels of bacterial endotoxin. Under normal circumstances, the immune tissues of the gut-liver axis inhibit the expression of a host response to foodstuffs in the gut lumen, or to the indigenous microbial flora of the gut wall. This influence is an active, energy-requiring process. Both strenuous exercise and critical illness are associated with gut ischemia, providing a common biologic basis for the initiation of a dysregulated inflammatory response. Although direct evidence supporting or refuting the hypothesis that the gut can serve as a trigger for systemic inflammation following strenuous exercise is sparse, the similarities in the clinical manifestations of SIRS and exercise, and the promising results of prophylactic or therapeutic gut-directed strategies in critical illness, suggest that similar approaches may provide benefit for individuals engaged in extreme physical exercise.