Gastrointestinal microecology: a crucial and potential target in acute pancreatitis
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In the early stage of acute pancreatitis (AP), abundant cytokines induced by local pancreatic inflammation enter the bloodstream, further cause systemic inflammatory response syndrome (SIRS) by “trigger effect”, which eventually leads to multiple organ dysfunction syndrome (MODS). During SIRS and MODS, the intestinal barrier function was seriously damaged accompanied by the occurrence of gut-derived infection which forms a “second hit summit” by inflammatory overabundance. Gastrointestinal microecology, namely the biologic barrier, could be transformed into a pathogenic state, which is called microflora dysbiosis when interfered by the inflammatory stress during AP. More and more evidences indicate that gastrointestinal microflora dysbiosis plays a key role in “the second hit” induced by AP gut-derived infection. Therefore, the maintenance of gastrointestinal microecology balance is likely to provide an effective method in modulating systemic infection of AP. This article reviewed the progress of gastrointestinal microecology in AP to provide a reference for deeply understanding the pathogenic mechanisms of AP and identifying new therapeutic targets.
KeywordsAcute pancreatitis Gastrointestinal microecology Intestinal barrier Systemic inflammatory response syndrome Enteral nutrition
Systemic inflammatory response syndrome
Multiple organ dysfunction syndrome
Severe acute pancreatitis
Pancreatitis-associated ascitic fluid
Proton pump inhibitor
Mild acute pancreatitis
Selective decontaminant of digestive tract
Fecal microbiota transplantation
This study was funded by the National Nature Scientific Foundation of China (Nos: 81100314, 81370565, 81770639), Nature Scientific Foundation of Heilongjiang Province (No: H201445), Wei-Han Yu scientific foundation of Harbin Medical University.
M-EC, FW, and YS reviewed the current literature and drafted the main part of the manuscript. W-JZ, and BS edited the manuscript and contributed by iteratively reviewing and improving the manuscript. GW edited the manuscript, gave oversight to draft the manuscript, and made substantive intellectual contributions and improvements. All authors read and approved the final manuscript.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
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