Impact of Endotoxemia on Chronic Non-communicable Diseases

Dear Colleagues,

Endotoxemia, the presence of endotoxins within the blood, is probably related to most, if not all, chronic non-communicable diseases worldwide. Endotoxemia can be caused by sterile substances such as nanoparticles and heavy metals, and also by pathogenic debris and non-digested food items. Endotoxemia is present in people suffering from a variety of diseases ranging from intervertebral disc hernia, rheumatoid arthritis and coeliac patients to individuals with Alzheimer’s and even stroke. Although the pathogenic load in all these tissues and the blood itself is difficult to assess, modern measurement techniques have increased sensitivity and specificity in endotoxemia testing in most mammals, including humans. Although perhaps unexpected, the majority of detected pathogens in tissues and blood come from the skin and the oropharyngeal space, although gut pathogens are also detected. The moment the ‘outer world’ infiltrates the body, an immune response is inevitable. Endotoxemia is therefore central to the development of a chronic low-grade inflammation, which itself produces damage possibly to all barriers causing a systemic inflammatory state. Obesity, metabolic syndrome, periodontal disease, pulmonary disorders, high stomach pH, cutaneous disorders, sedentary lifestyle, toxic nutrients, and many other factors can produce endotoxemia and its systemic disorders. Endotoxemia should therefore be considered the universal pathway of NCCD and perhaps even infectious diseases. The latter is based on the fact that the systemic inflammation is ‘low grade’, a metabolic constraint causing low activity of all immune components, including the acquired ones. The latter has been evidenced by the recent COVID-19 pandemic, in which individuals with metabolic disturbances related to insulin and leptin resistance were (and are) much more susceptible to the development of COVID-19. This issue is about how endotoxemia happens in susceptible individuals and the way pathogens are able to infiltrate the whole body, including the brain and our reproductive system. Endotoxemia is mostly a consequence of modern life, and mechanisms that explain how factors such as sitting time and nutrition can be responsible for systemic chronic inflammation through the development of endotoxemia are needed. As endotoxemia can affect every organ, tissue and system, all medical disciplines are invited to collaborate in this Special Issue, which could have a high impact on our daily clinical practice. As the International Journal of Molecular Sciences is a journal of molecular science, pure clinical studies will not be suitable for the journal. However, clinical submissions including biomolecular experiments are welcomed.

Dr. Leo Pruimboom
Guest Editor

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• endotoxemia
• endotoxins
• chronic non-communicable diseases
• chronic inflammation