{
  "abstract": "Colorectal anastomotic leakage is commonly framed as a technical complication or a consequence of intestinal dysbiosis. Neither view fully explains how a contaminated mucosal wound restores epithelial continuity while preserving a load-bearing submucosal matrix. We define anastomotic healing as a spatially organized mucosal immune process: luminal microbes and metabolites, the epithelial wound edge, recruited immune cells, fibroblasts, collagen, and vascular support occupy distinct but interacting compartments. The most compelling available anastomosis-specific evidence supports a destructive pathway in which expressed microbial virulence, host plasminogen activation, epithelial inflammatory signaling, sustained neutrophil recruitment, and MMP9 converge on collagen loss. A complementary repair pathway is supported by human-to-mouse microbiota-transfer and metabolite-rescue experiments, but this evidence is less direct and more heterogeneous. It links commensal function and AhR-dependent IL-22 signaling to epithelial restitution, myeloid resolution, and matrix repair. NLRP3, NLRP6, and NLRC4 remain candidate threshold regulators rather than demonstrated mediators of colorectal anastomotic healing. Human macrophage atlases refine cell-state definitions, but prospective evidence linking anastomotic macrophage states or efferocytosis to leakage remains limited. We propose an evidence-weighted framework that separates human association, direct microbial-function measurements, experimental causation, and human intervention evidence. Translation will require paired spatial sampling and functional microbial assays, together with immune, matrix, mechanical, target-engagement, and ecological-safety endpoints. This framework extends beyond taxonomic dysbiosis toward testable wound-immune endotypes and mechanism-matched prevention.",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Surgery, Binhai County People’s Hospital"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhixuan Xu"
    },
    {
      "affs": [
        0
      ],
      "name": "Weipeng Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Feng Lu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5gjbjs7ak3m0w.bib",
  "cited_by": 0,
  "doi": "10.3389/fimmu.2026.1928237",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13732322/",
  "id": "5gjbjs7ak3m0w",
  "issns": [
    "1664-3224"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1928237/full",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
    [
      "openalex",
      "1312|Gut microbiota and health"
    ]
  ],
  "openalex": "W7223148009",
  "pdf_url": "https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2026.1928237/pdf",
  "pmcid": "PMC13732322",
  "pmid": "42985468",
  "published": "2026-10-21",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/5gjbjs7ak3m0w.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:17Z",
      "native_id": "10.3389/fimmu.2026.1928237",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1928237/full"
    },
    {
      "first_seen": "2026-11-08T12:22:19Z",
      "native_id": "PMC13732322",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fimmu.2026.1928237"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1312|Gut microbiota and health",
      "subfield": "molecular-biology"
    }
  ],
  "title": "Microbial control of mucosal wound immunity in colorectal anastomotic healing: from barrier repair to matrix failure",
  "title_text": "Microbial control of mucosal wound immunity in colorectal anastomotic healing: from barrier repair to matrix failure",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:22:19Z",
  "url": "https://research.draconitic.com/paper/5gjbjs7ak3m0w",
  "venue": "Frontiers in Immunology",
  "versions": []
}