Evidence map›Paper›PMID 33023827›Full record

ReviewDigestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver2020

Intestinal permeability changes with bacterial translocation as key events modulating systemic host immune response to SARS-CoV-2: A working hypothesis.

Vincenzo Cardinale, Gabriele Capurso, Gianluca Ianiro, Antonio Gasbarrini, Paolo Giorgio Arcidiacono, Domenico Alvaro

Open access · bronzeAbstract readReview
In one paragraph

Review in Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers.

0numbers the graph read from it
0cells of the map it votes in
56citing papers in PubMed
2.1field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

56 citing papers in PubMed, 108 citations in OpenAlex.

  1. Review
  2. Human brain matters: Navigating the neuropathology of COVID-19.Brain pathology (Zurich, Switzerland) · 2026
    Review
  3. Review
  4. Article
  5. Review
  6. Article
  7. Article
  8. Review
  9. Review
  10. Article
  11. Article
  12. Modulatory role ofiScience · 2024
    Article
  13. Article
  14. Article
  15. Review
  16. Gut microbiota and immunotherapy of renal cell carcinoma.Human vaccines & immunotherapeutics · 2023
    Review
  17. Risk factors for carbapenem-resistantJAC-antimicrobial resistance · 2023
    Article
  18. Review
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Vincenzo CardinaleDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Viale dell'Università 37, Rome 00185, Italy. Electronic address: vincenzo.cardinale@uniroma1.it.
Gabriele CapursoPancreato-biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, Italy.
Gianluca IaniroDigestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy.
Antonio GasbarriniDigestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy.
Paolo Giorgio ArcidiaconoPancreato-biliary Endoscopy and Endosonography Division, Pancreas Translational and Clinical Research Center, San Raffaele Scientific Institute IRCCS, Milan, Italy.
Domenico AlvaroDepartment of Translational and Precision Medicine, Sapienza University of Rome, Viale dell'Università 37, Rome 00185, Italy.
Agostino Gemelli University Polyclinic · ITSapienza University of Rome · ITVita-Salute San Raffaele University · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The microbiota-gut-liver-lung axis plays a bidirectional role in the pathophysiology of a number of infectious diseases. During the course of severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) and 2 (SARS-CoV-2) infection, this pathway is unbalanced due to intestinal involvement and systemic inflammatory response. Moreover, there is convincing preliminary evidence linking microbiota-gut-liver axis perturbations, proinflammatory status, and endothelial damage in noncommunicable preventable diseases with coronavirus disease 2019 (Covid-19) severity. Intestinal damage due to SARS-CoV-2 infection, systemic inflammation-induced dysfunction, and IL-6-mediated diffuse vascular damage may increase intestinal permeability and precipitate bacterial translocation. The systemic release of damage- and pathogen-associated molecular patterns (e.g. lipopolysaccharides) and consequent immune-activation may in turn auto-fuel vicious cycles of systemic inflammation and tissue damage. Thus, intestinal bacterial translocation may play an additive/synergistic role in the cytokine release syndrome in Covid-19. This review provides evidence on gut-liver axis involvement in Covid-19 as well as insights into the hypothesis that intestinal endotheliitis and permeability changes with bacterial translocation are key pathophysiologic events modulating systemic inflammatory response. Moreover, it presents an overview of readily applicable measures for the modulation of the gut-liver axis and microbiota in clinical practice.

Indexed as

PermeabilityAlarminsAngiotensin-Converting Enzyme 2Bacterial TranslocationCOVID-19Cytokine Release SyndromeDisease ProgressionGastrointestinal MicrobiomeHumansImmunityInflammationInterleukin-6Intestinal MucosaLipopolysaccharidesLiverLungAlarminsAngiotensin-Converting Enzyme 2Interleukin-6LipopolysaccharidesPathogen-Associated Molecular Pattern MoleculesSerine EndopeptidasesTMPRSS2 protein, humanCytokine release syndromeGut-liver axisMicrobiota modulationSARS-CoV-2 host response

Identifiers

PMID33023827
PMCPMC7494274
OpenAlexW3090513635

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.