de Punder · Frontiers in immunology 2015 · narrative review · n=?

Stress induces endotoxemia and low-grade inflammation by increasing barrier permeability.

Cited 321 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review and conceptual hypothesis paper without systematic search or original data.

PubMed 26029209 · doi:10.3389/fimmu.2015.00223 · record verified 2026-08-27

What was done

This is a narrative review and hypothesis paper. The authors synthesize existing literature to propose a mechanistic framework in which homeostatic stress responses alter intestinal barrier permeability, leading to bacterial translocation and chronic low-grade inflammation.

What was found

No quantitative findings, sample sizes, effect sizes, or statistical results are reported in the abstract. The authors hypothesize that stress-driven increases in gut permeability—initially an adaptive response to meet metabolic demands—permit bacterial toxins into the bloodstream, driving low-grade inflammation linked to non-communicable diseases.

Why it matters

The paper outlines a unifying physiological mechanism linking environmental stressors and lifestyle factors to systemic inflammation via gut barrier dysfunction. This conceptual model serves as a framework for designing future empirical trials.

Limits

The abstract provides no empirical data, statistical tests, or systematic review methodology. It relies on theoretical synthesis and observational associations cited from other literature, meaning causal relationships cannot be confirmed from this work alone.

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