The Importance of the Gut as a Central Organ in the Pathogenesis of MOF

  • M. P. Fink
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 17)


In 1988, Wilmore et al. [1] proposed that the intestinal tract plays a central role in the pathophysiologic responses to severe injury or infection. Others, including Deitch and colleagues [2], Border et al. [3], and Meakins and Marshall [4], also have championed this concept. The barest outlines for the gut hypothesis for multiple organ dysfunction (MOF) can be summarized as follows: “derangements in the barrier function of the gut permit the dissemination of intraluminal microbes and/or microbial products to mesenteric lymph nodes (MLN) or other organs (particularly the liver), which are downstream from the intestinal tract”. The pathological dissemination of microbes or microbial products beyond the confines of the intestinal lumen leads to pathological modulation of immune cells. This results in excessive release of a wide variety of pro-inflammatory mediators, including cytokines, such as IL- 1 and TNFα, and lipids, like PAF, which can promote organ injury via numerous mechanisms.


Hemorrhagic Shock Intestinal Permeability Bacterial Translocation Mesenteric Ischemia Microbial Translocation 
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© Springer-Verlag Berlin Heidelberg 1993

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  • M. P. Fink

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