Gut microbiota and sepsis-associated encephalopathy: pathogenesis and precision therapies

Sepsis is defined as a condition of immune dysregulation in response to an infection, and sepsis-associated encephalopathy (SAE) is often the initial symptom that manifests in patients with sepsis. This condition is characterized by its high mortality rates and the potential to cause significant dis...

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Main Authors: Na Wei, Shiyu Dai, Wei Li, Jun Zhou, Ye Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neuroscience
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Online Access:https://www.frontiersin.org/articles/10.3389/fnins.2025.1596467/full
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author Na Wei
Na Wei
Shiyu Dai
Shiyu Dai
Wei Li
Wei Li
Wei Li
Jun Zhou
Jun Zhou
Ye Chen
Ye Chen
author_facet Na Wei
Na Wei
Shiyu Dai
Shiyu Dai
Wei Li
Wei Li
Wei Li
Jun Zhou
Jun Zhou
Ye Chen
Ye Chen
author_sort Na Wei
collection DOAJ
description Sepsis is defined as a condition of immune dysregulation in response to an infection, and sepsis-associated encephalopathy (SAE) is often the initial symptom that manifests in patients with sepsis. This condition is characterized by its high mortality rates and the potential to cause significant disability among survivors. Despite its severity, the underlying pathophysiologic mechanisms that contribute to the development of SAE are not yet fully understood. Additionally, there are no established strict diagnostic criteria or potent treatment options available for this condition. However, an increasing body of evidence suggests that an imbalance in the gut microbiota is associated with SAE, potentially through the gut-brain axis (GBA). The GBA axis refers to the bidirectional communication between the gut microbiota and the central nervous system. In this review, we discuss the changes in the gut microbiota in SAE and the mechanisms of the GBA axis, involving neural, immune, endocrine, and neurotransmitter pathways. Finally, we conclude by evaluating the preclinical and clinical evidence for fecal microbiota transplantation and probiotics in SAE. Targeting the GBA axis will be an actionable target to ameliorate the development and progression of SAE.
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publisher Frontiers Media S.A.
record_format Article
series Frontiers in Neuroscience
spelling doaj-art-5a75a858e8bc420fa86de2a1170fec552025-08-20T02:43:36ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2025-07-011910.3389/fnins.2025.15964671596467Gut microbiota and sepsis-associated encephalopathy: pathogenesis and precision therapiesNa Wei0Na Wei1Shiyu Dai2Shiyu Dai3Wei Li4Wei Li5Wei Li6Jun Zhou7Jun Zhou8Ye Chen9Ye Chen10Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaAnesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaAnesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaAnesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Anesthesiology, Hejiang County People’s Hospital, Luzhou, Sichuan, ChinaDepartment of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaAnesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaAnesthesiology and Critical Care Medicine Key Laboratory of Luzhou, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Traditional Chinese Medicine, The Affiliated Hospital, Southwest Medical University, Luzhou, ChinaSepsis is defined as a condition of immune dysregulation in response to an infection, and sepsis-associated encephalopathy (SAE) is often the initial symptom that manifests in patients with sepsis. This condition is characterized by its high mortality rates and the potential to cause significant disability among survivors. Despite its severity, the underlying pathophysiologic mechanisms that contribute to the development of SAE are not yet fully understood. Additionally, there are no established strict diagnostic criteria or potent treatment options available for this condition. However, an increasing body of evidence suggests that an imbalance in the gut microbiota is associated with SAE, potentially through the gut-brain axis (GBA). The GBA axis refers to the bidirectional communication between the gut microbiota and the central nervous system. In this review, we discuss the changes in the gut microbiota in SAE and the mechanisms of the GBA axis, involving neural, immune, endocrine, and neurotransmitter pathways. Finally, we conclude by evaluating the preclinical and clinical evidence for fecal microbiota transplantation and probiotics in SAE. Targeting the GBA axis will be an actionable target to ameliorate the development and progression of SAE.https://www.frontiersin.org/articles/10.3389/fnins.2025.1596467/fullsepsis-associated encephalopathysepsisgut microbiotafecal microbiota transplantationprobiotics
spellingShingle Na Wei
Na Wei
Shiyu Dai
Shiyu Dai
Wei Li
Wei Li
Wei Li
Jun Zhou
Jun Zhou
Ye Chen
Ye Chen
Gut microbiota and sepsis-associated encephalopathy: pathogenesis and precision therapies
Frontiers in Neuroscience
sepsis-associated encephalopathy
sepsis
gut microbiota
fecal microbiota transplantation
probiotics
title Gut microbiota and sepsis-associated encephalopathy: pathogenesis and precision therapies
title_full Gut microbiota and sepsis-associated encephalopathy: pathogenesis and precision therapies
title_fullStr Gut microbiota and sepsis-associated encephalopathy: pathogenesis and precision therapies
title_full_unstemmed Gut microbiota and sepsis-associated encephalopathy: pathogenesis and precision therapies
title_short Gut microbiota and sepsis-associated encephalopathy: pathogenesis and precision therapies
title_sort gut microbiota and sepsis associated encephalopathy pathogenesis and precision therapies
topic sepsis-associated encephalopathy
sepsis
gut microbiota
fecal microbiota transplantation
probiotics
url https://www.frontiersin.org/articles/10.3389/fnins.2025.1596467/full
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