Sepsis is the main cause of death in critically ill patients and gut microbiota dysbiosis plays a crucial role in sepsis. On the one hand, sepsis leads to the destruction of gut microbiota and induces and aggravates terminal organ dysfunction. On the other hand, the activation of pathogenic gut flora and the reduction in beneficial microbial products increase the susceptibility of the host to sepsis. Although probiotics or fecal microbiota transplantation preserve gut barrier function on multiple levels, their efficacy in sepsis with intestinal microbiota disruptions remains uncertain. Postbiotics consist of inactivated microbial cells or cell components. They possess antimicrobial, immunomodulatory, antioxidant and antiproliferative activities. Microbiota-targeted therapy strategies, such as postbiotics, may reduce the incidence of sepsis and improve the prognosis of patients with sepsis by regulating gut microbial metabolites, improving intestinal barrier integrity and changing the composition of the gut microbiota. They offer a variety of mechanisms and might even be superior to more conventional ‘biotics’ such as probiotics and prebiotics. In this review, we present an overview of the concept of postbiotics and summarize what is currently known about postbiotics and their prospective utility in sepsis therapy. Overall, postbiotics show promise as a viable adjunctive therapy option for sepsis.

中文翻译：

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后生元作为败血症的潜在新治疗剂

脓毒症是危重患者死亡的主要原因，肠道菌群失调在脓毒症中起着至关重要的作用。一方面，脓毒症导致肠道菌群遭到破坏，诱发和加重终末器官功能障碍。另一方面，致病性肠道菌群的激活和有益微生物产物的减少增加了宿主对败血症的易感性。尽管益生菌或粪便微生物群移植在多个层面上保留了肠道屏障功能，但它们对肠道微生物群破坏引起的脓毒症的疗效仍不确定。后生元由灭活的微生物细胞或细胞成分组成。它们具有抗菌、免疫调节、抗氧化和抗增殖活性。针对微生物群的治疗策略，例如后生元、可能通过调节肠道微生物代谢产物、改善肠道屏障完整性、改变肠道菌群组成，降低脓毒症的发生率，改善脓毒症患者的预后。它们提供多种机制，甚至可能优于益生菌和益生元等更传统的“生物”。在这篇综述中，我们概述了后生元的概念，并总结了目前对后生元的了解及其在脓毒症治疗中的预期用途。总体而言，后生元有望成为败血症的可行辅助治疗选择。它们提供多种机制，甚至可能优于益生菌和益生元等更传统的“生物”。在这篇综述中，我们概述了后生元的概念，并总结了目前对后生元的了解及其在脓毒症治疗中的预期用途。总体而言，后生元有望成为败血症的可行辅助治疗选择。它们提供多种机制，甚至可能优于益生菌和益生元等更传统的“生物”。在这篇综述中，我们概述了后生元的概念，并总结了目前对后生元的了解及其在脓毒症治疗中的预期用途。总体而言，后生元有望成为败血症的可行辅助治疗选择。