Early Gut Mucosal Dysfunction in Patients With Acute Pancreatitis

Liu, Haiyan; Li, Weiqin; Wang, Xinying; Li, Jieshou; Yu, Wenkui

doi:10.1097/mpa.0b013e31815a399f

Cited by 103 publications

(88 citation statements)

References 23 publications

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“…Increased intestinal permeability was confirmed by several methods in patients with acute pancreatitis [77,78,79,80]. The intestinal permeability was correlated with plasma endotoxin [77,79,80], serum TNF-α [77,80], IL-6, CRP, and the severity index estimated by computed tomography [80].…”

Section: Acute Pancreatitismentioning

confidence: 99%

“…The intestinal permeability was correlated with plasma endotoxin [77,79,80], serum TNF-α [77,80], IL-6, CRP, and the severity index estimated by computed tomography [80]. The urinary concentration of intestinal fatty acid-binding protein, a sensitive marker of intestinal ischemia, correlated positively with intestinal permeability, which suggests that splanchnic hypoperfusion induces the loss of intestinal mucosal integrity [78].…”

Section: Acute Pancreatitismentioning

confidence: 99%

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Increased Intestinal Permeability and Decreased Barrier Function: Does It Really Influence the Risk of Inflammation?

2016

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Background: Increased intestinal permeability due to barrier dysfunction is supposed to cause microbial translocation which may induce low-grade inflammation in various diseases. However, this series of events has not been comprehensively evaluated yet. Summary: Intestinal epithelial barrier dysfunction and increased permeability have been described in patients with inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), alcoholic liver disease, nonalcoholic steatohepatitis (NASH), liver cirrhosis, acute pancreatitis, primary biliary cholangitis (PBC), type 1 and type 2 diabetes, chronic kidney disease, chronic heart failure (CHF), depression, and other diseases. Most clinical reports used either permeability assays of challenge tests or measurement of circulating bacterial markers like endotoxin for assessment of ‘the leaky gut'. The intestinal permeability assessed by the challenge tests has often been related to the changes of tight junction proteins in the epithelium or circulating endotoxin levels. In patients with IBD, alcoholic liver disease, NASH, liver cirrhosis, PBC, obstructive jaundice, severe acute pancreatitis, and CHF, endotoxemia and proinflammatory cytokinemia have been found in addition to increased permeability. In the serum of patients with IBS and depression, antiflagellin antibodies and antilipid A antibodies were detected, respectively, together with increased permeability and proinflammatory cytokinemia. The site of infection, which is localized to the intestine in IBD and IBS, includes various extraintestinal organs in other diseases. The relation of gut dysbiosis to intestinal barrier dysfunction has gradually been clarified. Key Messages: Although no direct cause-and-effect relationship has been confirmed, all clinical and experimental data suggest the importance of intestinal hyperpermeability in the inflammatory changes of various diseases. Increased intestinal permeability is a new target for disease prevention and therapy. Considering the close relationship of ‘the leaky gut' and gut dysbiosis to the major diseases, we can conclude that meticulous dietetic and probiotic approaches to recover healthy microbiota have the potential to make a breakthrough in the management of these diseases tomorrow.

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Section: Acute Pancreatitismentioning

confidence: 99%

Section: Acute Pancreatitismentioning

confidence: 99%

Increased Intestinal Permeability and Decreased Barrier Function: Does It Really Influence the Risk of Inflammation?

2016

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“…Possible relationship between psoriasis and pancreatitis remains an enigma. A noteworthy hypothesis could be that of intestinal barrier dysfunction, all the more since some authors reported increased intestinal permeability in patients with acute pancreatitis [44,45]. There is, however, another possibility.…”

Section: Discussionmentioning

confidence: 93%

Psoriasis vulgaris and digestive system disorders: is there a linkage?

Pietrzak

Jastrzębska²,

Chodorowska³

et al. 2010

Folia Histochem Cytobiol.

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Psoriasis is well-known immune-mediated skin disease often associated with co-morbidities, including dyslipidaemia and obesity. Few reports imply that the disease might be also related to pathology of mucosal surfaces, especially that of the digestive system. The authors present a case of psoriasis and concurrent digestive system abnormalities, and review the literature regarding the topic. A 40-year-old man suffered from an exacerbation of exudative psoriasis for about 6 months. Topical antipsoriatics proved ineffective and the disease gradually progressed to a severe disseminated form. Subsequent detailed examinations revealed persistent gastroduodenitis due to H. pylori infection, pancreatic dysfunction and fatty change of the liver, although the patient denied any gastrointestinal symptoms. As a result appropriate treatment of the diagnosed digestive system disorders was added to topical antipsoriatic therapy. Within 2 weeks of treatment clinical symptoms and laboratory signs showed a marked trend to normalisation. The presented medical history seems to suggest that there may be some kind of interplay between psoriasis and digestive system disorders.

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“…Researchers have found that inflammatory mediators contribute to early SAP causing systemic epithelial barrier dysfunction [22] and increased vascular endothelial permeability [23]. The gut fuels SAP [24], which activates development of a local or systemic inflammation response and secondary infection of pancreatic necrosis [22,25].…”

Section: Discussionmentioning

confidence: 99%

Clinical observation of immunity in patients with secondary infection from severe acute pancreatitis

Shen

Cui

2012

Inflamm. Res.

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Early Gut Mucosal Dysfunction in Patients With Acute Pancreatitis

Abstract: Intestinal mucosal function is injured in early phase of AP especially in patients with organ dysfunction, which may be a stimulus for development of multiple organ dysfunction and correlate with bad outcome in AP patients.

Cited by 103 publications

References 23 publications

Increased Intestinal Permeability and Decreased Barrier Function: Does It Really Influence the Risk of Inflammation?

Increased Intestinal Permeability and Decreased Barrier Function: Does It Really Influence the Risk of Inflammation?

Psoriasis vulgaris and digestive system disorders: is there a linkage?

Clinical observation of immunity in patients with secondary infection from severe acute pancreatitis

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