Impact of enteric bacterial infections at and beyond the epithelial barrier

• Published in: Nature reviews. Microbiology 2023-04, Vol.21 (4), p.260-274
• Main Authors: Rogers, Ashleigh P., Mileto, Steven J., Lyras, Dena
• Format: Article
• Language: English
• Subjects: 631/326/107; 631/326/1320; 631/326/41/2531; 631/326/41/2533; 631/326/421; Bacteria; Bacterial diseases; Bacterial infections; Biomedical and Life Sciences; Complications; Damage; Digestive system; Enterobacteriaceae Infections; Gastrointestinal tract; Humans; Infections; Infectious Diseases; Inflammation; Intestine; Life Sciences; Medical Microbiology; Microbiology; Microbiota; Microorganisms; Parasitology; Pathogens; Perturbation; Review Article; Secretions; Stem cells; Virology
• ISSN: 1740-1526; 1740-1534
• DOI: 10.1038/s41579-022-00794-x

The mucosal lining of the gut has co-evolved with a diverse microbiota over millions of years, leading to the development of specialized mechanisms to actively limit the invasion of pathogens. However, some enteric microorganisms have adapted against these measures, developing ways to hijack or overcome epithelial micro-integrity mechanisms. This breach of the gut barrier not only enables the leakage of host factors out of circulation but can also initiate a cascade of detrimental systemic events as microbiota, pathogens and their affiliated secretions passively leak into extra-intestinal sites. Under normal circumstances, gut damage is rapidly repaired by intestinal stem cells. However, with substantial and deep perturbation to the gut lining and the systemic dissemination of gut contents, we now know that some enteric infections can cause the impairment of host regenerative processes. Although these local and systemic aspects of enteric disease are often studied in isolation, they heavily impact one another. In this Review, by examining the journey of enteric infections from initial establishment to systemic sequelae and how, or if, the host can successfully repair damage, we will tie together these complex interactions to provide a holistic overview of the impact of enteric infections at and beyond the epithelial barrier. In this Review, Rogers, Mileto and Lyras explore the impact of enteric bacterial infections at and beyond the epithelial barrier. They highlight how different bacterial pathogens disrupt structural first line defences of the gut, the influence this has on the systemic dissemination of gut contents, the acute inflammatory processes that are triggered and the collective implication of these events on the regeneration of efficient barrier functions.