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中华肝脏外科手术学电子杂志 ›› 2025, Vol. 14 ›› Issue (03) : 481 -486. doi: 10.3877/cma.j.issn.2095-3232.2025.03.023

综述

肠道菌群在胰腺炎发生发展中的研究进展
兰永1, 刘晶2, 杨志琦2, 吴浪2, 沙小春1, 李明皓2,()   
  1. 1. 750004 银川,宁夏医科大学
    2. 750004 银川,宁夏回族自治区人民医院肝胆外科
  • 收稿日期:2024-11-29 出版日期:2025-06-10
  • 通信作者: 李明皓
  • 基金资助:
    宁夏回族自治区自然科学基金(2024AAC03524)

Research progress in gut microbes in the incidence and development of pancreatitis

Yong Lan1, Jing Liu2, Zhiqi Yang2, Lang Wu2, Xiaochun Sha1, Minghao Li2,()   

  1. 1. Ningxia Medical University,Yinchuan 750004,China
    2. Department of Hepatobiliary Surgery,People's Hospital of Ningxia Hui Autonomous Region,Yinchuan 750004,China
  • Received:2024-11-29 Published:2025-06-10
  • Corresponding author: Minghao Li
引用本文:

兰永, 刘晶, 杨志琦, 吴浪, 沙小春, 李明皓. 肠道菌群在胰腺炎发生发展中的研究进展[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(03): 481-486.

Yong Lan, Jing Liu, Zhiqi Yang, Lang Wu, Xiaochun Sha, Minghao Li. Research progress in gut microbes in the incidence and development of pancreatitis[J/OL]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2025, 14(03): 481-486.

急性胰腺炎(AP)是消化系统常见的急腹症之一,病情程度轻重不一,常伴有胰腺或胰周的感染,尤其是发展为急性坏死性胰腺炎,极大增加多器官功能衰竭及死亡的风险,而且发病率呈不断上升趋势。既往对于AP合并肠道菌群变化及治疗管理方面的研究取得了极大进步,但肠道菌群的多样性、复杂性及其与靶器官之间的作用仍存在错综复杂的关系。AP患者不仅表现出肠道屏障功能受损,菌群多样性改变,而且局部或全身炎症刺激诱导肠道细菌移位增加,两者之间形成恶性循环,进一步增加了重症患者的比例。因此恢复肠黏膜屏障功能,改善肠道菌群可能是阻断疾病进展的关键所在。故本文综合既往研究报道,对AP过程中肠黏膜屏障损害及肠道菌群失调的变化作一综述,旨为疾病的治疗提供理论依据。

Acute pancreatitis (AP) is one of the common acute abdomen in the digestive system. It varies in disease severity, constantly complicated with pancreatic or peripancreatic infection. Especially if AP progresses into acute necrotizing pancreatitis, it will significantly increase the risk of multiple organ failure and even death. In addition, the incidence rate of AP is on the rise. Tremendous progress has been made in the study of the changes and treatment of gut microbes in AP patients. However, complicated relationship exists between the diversity and complexity of gut microbes and its role in target organs. AP patients not only develop impaired intestinal barrier function and altered microbial diversity, but also experience increased intestinal bacterial translocation induced by local or systemic inflammatory stimuli, forming a vicious circle and further elevating the proportion of critically ill patients. Therefore, restoring intestinal mucosal barrier function and diversifying gut microbes may be the key to prevent disease progression. In this article, the changes of intestinal mucosal barrier damage and intestinal microbiota imbalance during AP were reviewed by retrieving relevant literature, aiming to provide theoretical basis for the treatment of AP.

[1]
Petrov MS, Yadav D. Global epidemiology and holistic prevention of pancreatitis[J]. Nat Rev Gastroenterol Hepatol, 2019, 16(3): 175-184.DOI: 10.1038/s41575-018-0087-5.
[2]
Mederos MA, Reber HA, Girgis MD. Acute pancreatitis: a review[J].JAMA, 2021, 325(4): 382-390. DOI: 10.1001/jama.2020.20317.
[3]
Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1): 102-111.DOI: 10.1136/gutjnl-2012-302779.
[4]
Jain S, Mahapatra SJ, Gupta S, et al. Infected pancreatic necrosis due to multidrug-resistant organisms and persistent organ failure predict mortality in acute pancreatitis[J]. Clin Transl Gastroenterol, 2018,9(10): 190. DOI: 10.1038/s41424-018-0056-x.
[5]
Girdhar K, Soto M, Huang Q, et al. Gut microbiota regulate pancreatic growth, exocrine function, and gut hormones[J]. Diabetes,2022, 71(5): 945-960. DOI: 10.2337/db21-0382.
[6]
Wang Z, Li F, Liu J, et al. Intestinal microbiota - an unmissable bridge to severe acute pancreatitis-associated acute lung injury[J]. Front Immunol, 2022, 13: 913178. DOI: 10.3389/fimmu.2022.913178.
[7]
Adak A, Khan MR. An insight into gut microbiota and its functionalities[J]. Cell Mol Life Sci, 2019, 76(3): 473-493. DOI:10.1007/s00018-018-2943-4.
[8]
Sun C, Dong S, Chen W, et al. Berberine alleviates Alzheimer’s disease by regulating the gut microenvironment, restoring the gut barrier and brain-gut axis balance[J]. Phytomedicine, 2024, 129:155624. DOI: 10.1016/j.phymed.2024.155624.
[9]
Thomas RM, Jobin C. Microbiota in pancreatic health and disease:the next frontier in microbiome research[J]. Nat Rev Gastroenterol Hepatol, 2020, 17(1): 53-64. DOI: 10.1038/s41575-019-0242-7.
[10]
Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing[J]. Nature, 2010, 464(7285):59-65. DOI: 10.1038/nature08821.
[11]
Turner JR. Intestinal mucosal barrier function in health and disease[J].Nat Rev Immunol, 2009, 9(11): 799-809. DOI: 10.1038/nri2653.
[12]
Peterson LW, Artis D. Intestinal epithelial cells: regulators of barrier function and immune homeostasis[J]. Nat Rev Immunol, 2014, 14(3):141-153. DOI: 10.1038/nri3608.
[13]
Kurashima Y, Kiyono H. Mucosal ecological network of epithelium and immune cells for gut homeostasis and tissue healing[J].Annu Rev Immunol, 2017, 35: 119-147. DOI: 10.1146/annurevimmunol-051116-052424.
[14]
Fu Y, Mei Q, Yin N, et al. Paneth cells protect against acute pancreatitis via modulating gut microbiota dysbiosis[J]. mSystems,2022, 7(3): e0150721. DOI: 10.1128/msystems.01507-21.
[15]
Yin N, Xu B, Huang Z, et al. Inhibition of Pck1 in intestinal epithelial cells alleviates acute pancreatitis via modulating intestinal homeostasis[J]. FASEB J, 2024, 38(8): e23618. DOI: 10.1096/fj.202400039R.
[16]
Wu H, Xie S, Miao J, et al. Lactobacillus reuteri maintains intestinal epithelial regeneration and repairs damaged intestinal mucosa[J]. Gut Microbes, 2020, 11(4): 997-1014. DOI: 10.1080/19490976.2020.1734423.
[17]
Zhao L, Xie Q, Evivie SE, et al. Bifidobacterium dentium N8 with potential probiotic characteristics prevents LPS-induced intestinal barrier injury by alleviating the inflammatory response and regulating the tight junction in Caco-2 cell monolayers[J]. Food Funct, 2021,12(16): 7171-7184. DOI: 10.1039/d1fo01164b.
[18]
Paone P, Cani PD. Mucus barrier, mucins and gut microbiota: the expected slimy partners?[J]. Gut, 2020, 69(12): 2232-2243. DOI:10.1136/gutjnl-2020-322260.
[19]
Breugelmans T, Oosterlinck B, Arras W, et al. The role of mucins in gastrointestinal barrier function during health and disease[J]. Lancet Gastroenterol Hepatol, 2022, 7(5): 455-471. DOI: 10.1016/S2468-1253(21)00431-3.
[20]
Shimizu K, Ojima M, Ogura H. Gut microbiota and probiotics/synbiotics for modulation of immunity in critically ill patients[J].Nutrients, 2021, 13(7): 2439. DOI: 10.3390/nu13072439.
[21]
Gustafsson JK, Johansson MEV. The role of goblet cells and mucus in intestinal homeostasis[J]. Nat Rev Gastroenterol Hepatol, 2022,19(12): 785-803. DOI: 10.1038/s41575-022-00675-x.
[22]
Yu S, Xiong Y, Fu Y, et al. Shotgun metagenomics reveals significant gut microbiome features in different grades of acute pancreatitis[J]. Microb Pathog, 2021, 154: 104849. DOI: 10.1016/j.micpath.2021.104849.
[23]
Sovran B, Hugenholtz F, Elderman M, et al. Age-associated impairment of the mucus barrier function is associated with profound changes in microbiota and immunity[J]. Sci Rep, 2019, 9(1): 1437.DOI: 10.1038/s41598-018-35228-3.
[24]
Hao W, Hao C, Wu C, et al. Aluminum induced intestinal dysfunction via mechanical, immune, chemical and biological barriers[J].Chemosphere, 2022, 288(Pt 2): 132556. DOI: 10.1016/j.chemosphere.2021.132556.
[25]
Hand TW, Reboldi A. Production and function of immunoglobulin A[J]. Annu Rev Immunol, 2021, 39: 695-718. DOI: 10.1146/annurevimmunol-102119-074236.
[26]
Rollenske T, Burkhalter S, Muerner L, et al. Parallelism of intestinal secretory IgA shapes functional microbial fitness[J]. Nature, 2021,598(7882): 657-661. DOI: 10.1038/s41586-021-03973-7.
[27]
Glaubitz J, Wilden A, Frost F, et al. Activated regulatory T-cells promote duodenal bacterial translocation into necrotic areas in severe acute pancreatitis[J]. Gut, 2023, 72(7): 1355-1369. DOI: 10.1136/gutjnl-2022-327448.
[28]
Zhu Y, Wang X, Zhu L, et al. Lactobacillus rhamnosus GG combined with inosine ameliorates alcohol-induced liver injury through regulation of intestinal barrier and Treg/Th1 cells[J]. Toxicol Appl Pharmacol, 2022, 439: 115923. DOI: 10.1016/j.taap.2022.115923.
[29]
Wei H, Wang JY. Role of polymeric immunoglobulin receptor in IgA and IgM transcytosis[J]. Int J Mol Sci, 2021, 22(5): 2284. DOI:10.3390/ijms22052284.
[30]
Qiu YF, Ye J, Xie JJ, et al. Pancreatitis affects gut microbiota via metabolites and inflammatory cytokines: an exploratory two-step Mendelian randomisation study[J]. Mol Genet Genomics, 2024,299(1): 36. DOI: 10.1007/s00438-024-02125-6.
[31]
Ammer-Herrmenau C, Pfisterer N, Weingarten MF, et al. The microbiome in pancreatic diseases: recent advances and future perspectives[J]. United European Gastroenterol J, 2020, 8(8): 878-885. DOI: 10.1177/2050640620944720.
[32]
Frost F, Kacprowski T, Rühlemann M, et al. Impaired exocrine pancreatic function associates with changes in intestinal microbiota composition and diversity[J]. Gastroenterology, 2019, 156(4): 1010-1015. DOI: 10.1053/j.gastro.2018.10.047.
[33]
Pan LL, Li BB, Pan XH, et al. Gut microbiota in pancreatic diseases:possible new therapeutic strategies[J]. Acta Pharmacol Sin, 2021,42(7): 1027-1039. DOI: 10.1038/s41401-020-00532-0.
[34]
Liu J, Yan Q, Li S, et al. Integrative metagenomic and metabolomic analyses reveal the potential of gut microbiota to exacerbate acute pancreatitis[J]. NPJ Biofilms Microbiomes, 2024, 10(1): 29. DOI:10.1038/s41522-024-00499-4.
[35]
Zou M, Yang Z, Fan Y, et al. Gut microbiota on admission as predictive biomarker for acute necrotizing pancreatitis[J]. Front Immunol, 2022, 13: 988326. DOI: 10.3389/fimmu.2022.988326.
[36]
Wang Z, Guo M, Li J, et al. Composition and functional profiles of gut microbiota reflect the treatment stage, severity, and etiology of acute pancreatitis[J]. Microbiol Spectr, 2023, 11(5): e0082923. DOI:10.1128/spectrum.00829-23.
[37]
Ammer-Herrmenau C, Antweiler KL, Asendorf T, et al. Gut microbiota predicts severity and reveals novel metabolic signatures in acute pancreatitis[J]. Gut, 2024, 73(3): 485-495. DOI: 10.1136/gutjnl-2023-330987.
[38]
Severino A, Varca S, Airola C, et al. Antibiotic utilization in acute pancreatitis: a narrative review[J]. Antibiotics, 2023, 12(7): 1120.DOI: 10.3390/antibiotics12071120.
[39]
Liu J, Luo M, Qin S, et al. Significant succession of intestinal bacterial community and function during the initial 72 hours of acute pancreatitis in rats[J]. Front Cell Infect Microbiol, 2022, 12: 808991.DOI: 10.3389/fcimb.2022.808991.
[40]
Ciocan D, Rebours V, Voican CS, et al. Characterization of intestinal microbiota in alcoholic patients with and without alcoholic hepatitis or chronic alcoholic pancreatitis[J]. Sci Rep, 2018, 8(1): 4822. DOI:10.1038/s41598-018-23146-3.
[41]
Hu X, Han Z, Zhou R, et al. Altered gut microbiota in the early stage of acute pancreatitis were related to the occurrence of acute respiratory distress syndrome[J]. Front Cell Infect Microbiol, 2023,13: 1127369. DOI: 10.3389/fcimb.2023.1127369.
[42]
Tan YQ, Wang YN, Feng HY, et al. Host/microbiota interactionsderived tryptophan metabolites modulate oxidative stress and inflammation via aryl hydrocarbon receptor signaling[J]. Free Radic Biol Med, 2022, 184: 30-41. DOI: 10.1016/j.freeradbiomed.2022.03.025.
[43]
Li H, Xie J, Guo X, et al. Bifidobacterium spp. and their metabolite lactate protect against acute pancreatitis via inhibition of pancreatic and systemic inflammatory responses[J]. Gut Microbes, 2022, 14(1):2127456. DOI: 10.1080/19490976.2022.2127456.
[44]
Sendler M, van den Brandt C, Glaubitz J, et al. NLRP3 inflammasome regulates development of systemic inflammatory response and compensatory anti-inflammatory response syndromes in mice with acute pancreatitis[J]. Gastroenterology, 2020, 158(1): 253-269.e14.DOI: 10.1053/j.gastro.2019.09.040.
[45]
Yazici C, Thaker S, Castellanos KK, et al. Diet, gut microbiome,and their end metabolites associate with acute pancreatitis risk[J].Clin Transl Gastroenterol, 2023, 14(7): e00597. DOI: 10.14309/ctg.0000000000000597.
[46]
Mattke J, Darden CM, Lawrence MC, et al. Toll-like receptor 4 in pancreatic damage and immune infiltration in acute pancreatitis[J].Front Immunol, 2024, 15: 1362727. DOI: 10.3389/fimmu.2024.1362727.
[47]
Sharif R, Dawra R, Wasiluk K, et al. Impact of toll-like receptor 4 on the severity of acute pancreatitis and pancreatitis-associated lung injury in mice[J]. Gut, 2009, 58(6): 813-819. DOI: 10.1136/gut.2008.170423.
[48]
Mei QX, Fu Y, Huang ZH, et al. Intestinal TLR4 deletion exacerbates acute pancreatitis through gut microbiota dysbiosis and Paneth cells deficiency[J]. Gut Microbes, 2022, 14(1): 2112882. DOI:10.1080/19490976.2022.2112882.
[49]
Gasaly N, de Vos P, Hermoso MA. Impact of bacterial metabolites on gut barrier function and host immunity: a focus on bacterial metabolism and its relevance for intestinal inflammation[J]. Front Immunol, 2021, 12: 658354. DOI: 10.3389/fimmu.2021.658354.
[50]
Martin-Gallausiaux C, Marinelli L, Blottière HM, et al. SCFA:mechanisms and functional importance in the gut[J]. Proc Nutr Soc,2021, 80(1): 37-49. DOI: 10.1017/S0029665120006916.
[51]
Xia H, Guo J, Shen J, et al. Ketogenic diet exacerbates L-arginineinduced acute pancreatitis and reveals the therapeutic potential of butyrate[J]. Nutrients, 2023, 15(20): 4427. DOI: 10.3390/nu15204427.
[52]
Tran QT, Tran VH, Sendler M, et al. Role of bile acids and bile salts in acute pancreatitis: from the experimental to clinical studies[J].Pancreas, 2021, 50(1): 3-11. DOI: 10.1097/MPA.0000000000001706.
[53]
Tran QT, Sendler M, Wiese ML, et al. Systemic bile acids affect the severity of acute pancreatitis in mice depending on their hydrophobicity and the disease pathogenesis[J]. Int J Mol Sci, 2022,23(21): 13592. DOI: 10.3390/ijms232113592.
[54]
Tenner S, Vege SS, Sheth SG, et al. American college of gastroenterology guidelines: management of acute pancreatitis[J].Am J Gastroenterol, 2024, 119(3): 419-437. DOI: 10.14309/ajg.0000000000002645.
[55]
Chan KS, Shelat VG. The ongoing debate on the use of prophylactic antibiotics in acute pancreatitis-is there a conclusion? A comprehensive narrative review[J]. Antibiotics, 2024, 13(5): 411.DOI: 10.3390/antibiotics13050411.
[56]
李幼生.抗生素在重症急性胰腺炎治疗中的合理应用:争议与进展[J].中华医学杂志,2021, 101(30): 2346-2348. DOI:10.3760/cma.j.cn112137-20210307-00580.Li YS. Rational use of antibiotics in severe acute pancreatitis:controversy and progress[J]. Zhonghua Yi Xue Za Zhi, 2021, 101(30):2346-2348. DOI: 10.3760/cma.j.cn112137-20210307-00580.
[57]
Poropat G, Goričanec K, Lacković A, et al. Systematic review with trial sequential analysis of prophylactic antibiotics for acute pancreatitis[J]. Antibiotics, 2022, 11(9): 1191. DOI: 10.3390/antibiotics11091191.
[58]
Ding N, Sun YH, Wen LM, et al. Assessment of prophylactic antibiotics administration for acute pancreatitis: a meta-analysis of randomized controlled trials[J]. Chin Med J, 2020, 133(2): 212-220.DOI: 10.1097/CM9.0000000000000603.
[59]
Huang FC, Lu YT, Liao YH. Beneficial effect of probiotics on Pseudomonas aeruginosa-infected intestinal epithelial cells through inflammatory IL-8 and antimicrobial peptide human betadefensin-2 modulation[J]. Innate Immun, 2020, 26(7): 592-600. DOI:10.1177/1753425920959410.
[60]
Pan LL, Niu W, Fang X, et al. Clostridium butyricum strains suppress experimental acute pancreatitis by maintaining intestinal homeostasis[J]. Mol Nutr Food Res, 2019, 63(13): e1801419. DOI:10.1002/mnfr.201801419.
[61]
Snigdha S, Ha K, Tsai P, et al. Probiotics: potential novel therapeutics for microbiota-gut-brain axis dysfunction across gender and lifespan[J]. Pharmacol Ther, 2022, 231: 107978. DOI: 10.1016/j.pharmthera.2021.107978.
[62]
Roe AL, Boyte ME, Elkins CA, et al. Considerations for determining safety of probiotics: a USP perspective[J]. Regul Toxicol Pharmacol,2022, 136: 105266. DOI: 10.1016/j.yrtph.2022.105266.
[63]
Wang M, Xie X, Zhao S, et al. Fecal microbiota transplantation for irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials[J]. Front Immunol, 2023, 14: 1136343.DOI: 10.3389/fimmu.2023.1136343.
[64]
Huang C, Huang C, Tian R, et al. Washed microbiota transplantation via colonic transendoscopic enteral tube rescues severe acute pancreatitis: a case series[J]. Heliyon, 2024, 10(13): e33678. DOI:10.1016/j.heliyon.2024.e33678.
[65]
Porcari S, Severino A, Rondinella D, et al. Fecal microbiota transplantation for recurrent Clostridioides difficile infection in patients with concurrent ulcerative colitis[J]. J Autoimmun, 2023,141: 103033. DOI:10.1016/j.jaut.2023.103033.
[66]
Liu LW, Xie Y, Li GQ, et al. Gut microbiota-derived nicotinamide mononucleotide alleviates acute pancreatitis by activating pancreatic SIRT3 signalling[J]. Br J Pharmacol, 2023, 180(5): 647-666. DOI:10.1111/bph.15980.
[67]
Marcella C, Cui B, Kelly CR, et al. Systematic review: the global incidence of faecal microbiota transplantation-related adverse events from 2000 to 2020[J]. Aliment Pharmacol Ther, 2021, 53(1): 33-42.DOI: 10.1111/apt.16148.
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