Role of gut microbiota on intestinal barrier function in acute pancreatitis

Li, Xue-Yang; He, Cong; Zhu, Yin; Lü, Nonghua

doi:10.3748/wjg.v26.i18.2187

Cited by 148 publications

(103 citation statements)

References 45 publications

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“…Lack of enteral nutrition (EN) has been proven not only to change the composition of the intestinal epithelial barrier function, but to cause bacterial translocation, and promote the occurrence of infectious complications such as pancreatic infection and peripancreatic necrosis, which aggravates the patient's systemic inflammatory response to a certain extent. Therefore, active and effective nutritional support is of vital importance for maintaining and improving the nutritional status of AP patients, maintaining intestinal barrier function, inhibiting bacterial translocation, and reducing systemic inflammatory response (3,112,113). Compared to PN, EN or oral intake does not increase the risk of adverse events and may shorten the length of hospital stay in patients with AP (114,115).…”

Section: Use Of Analgesicsmentioning

confidence: 99%

A narrative review of acute pancreatitis and its diagnosis, pathogenetic mechanism, and management

Zheng

Ding

et al. 2021

Ann Transl Med

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Acute pancreatitis (AP) is an inflammatory disease that can progress to severe acute pancreatitis (SAP), which increases the risk of death. AP is characterized by inappropriate activation of trypsinogen, infiltration of inflammatory cells, and destruction of secretory cells. Other contributing factors may include calcium (Ca 2+ ) overload, mitochondrial dysfunction, impaired autophagy, and endoplasmic reticulum (ER) stress. In addition, exosomes are also associated with pathophysiological processes of many human diseases and may play a biological role in AP. However, the pathogenic mechanism has not been fully elucidated and needs to be further explored to inform treatment. Recently, the treatment guidelines have changed; minimally invasive therapy is advocated more as the core multidisciplinary participation and "step-up" approach. The surgical procedures have gradually changed from open surgery to minimally invasive surgery that primarily includes percutaneous catheter drainage (PCD), endoscopy, small incision surgery, and video-assisted surgery. The current guidelines for the management of AP have been updated and revised in many aspects. The type of fluid to be used, the timing, volume, and speed of administration for fluid resuscitation has been controversial. In addition, the timing and role of nutritional support and prophylactic antibiotic therapy, as well as the timing of the surgical or endoscopic intervention, and the management of complications still have many uncertainties that could negatively impact the prognosis and patients' quality of life. Consequently, to inform clinicians about optimal treatment, we aimed to review recent advances in the understanding of the pathogenesis of AP and its diagnosis and management.

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Section: Use Of Analgesicsmentioning

confidence: 99%

A narrative review of acute pancreatitis and its diagnosis, pathogenetic mechanism, and management

Zheng

Ding

et al. 2021

Ann Transl Med

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“…Some of these species help strengthen and maintain the mucosal barrier, which protects cells from acids in the stomach and other digestive enzymes. In addition to their role in digestion, gut microbes interact with the mucosal immune system to facilitate disease detection and management [48][49] . They also contribute to enzyme production.…”

Section: Benefits Of the Microbiotamentioning

confidence: 99%

Microbiota and their Influence in the Human Body

Al-Judaibi¹

2021

J Pure Appl Microbiol

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Scientists have invested considerable resources in the study of the microbiota of the human body. These microorganisms play pivotal roles in immunity and disease. Of which, probiotics are live beneficial microorganisms that keep your intestinal or lung microbiota healthy, and occupy a special role in combating the infections. Thus, it is critical to understand their contributions to these processes. Technology can facilitate advanced studies of the microbiota, including how it develops and its positive and negatives effects on the immune system. This paper investigates how several factors (e.g. birth delivery mode, metabolic activities, types of microorganisms, and immune system interactions) affect the microbiota, particularly in early life. The paper also discusses how gastrointestinal microbes in particular may be associated with certain disease processes, such as those related to schizophrenia, autism, and diabetes. Clinical studies show that certain probiotic strains, like Lactobacillus rhamnosus GG and Bifidobacterium animalis ssp. lactis help to prevent infection of pathogenic organisms (both bacterial and viral). This research may yield crucial contributions to disease prevention and public health. The dysbiosis may result in changes in the acquired immunity later on. The probiotic strains can prevent viral replication during SARS-CoV-2 or COVID-19 infection by reducing proinflammatory cytokines. There has been much interest into the intestinal flora as proposed by the diversity, volume, and proposed role in disease. Future research in the field of microbiome should be done in order to uncover their association to gut virome by noting both their influence on each other and relevant health and disease.

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“…The gut barrier dysfunction is a common and well-recognized phenomenon in SAP [50]. Enteral feeding has a clear benefit in reducing morbidity and mortality over parenteral nutrition [51].…”

Section: Enteral Nutritionmentioning

confidence: 99%

Management of Severe Acute Pancreatitis

Lee

Papachristou

2020

Curr Treat Options Gastro

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Purpose of review There have been significant advancements in different aspects of management of severe acute pancreatitis (SAP). Our review of the most recent literature focuses on severity prediction, fluid resuscitation, analgesic administration, nutrition, and endoscopic intervention for SAP and its extra-pancreatic complications. Recent findings Recent studies on serum cytokines for the prediction of SAP have shown superior prognostic performance when compared with conventional laboratory tests and clinical scoring systems. In patients with established SAP and vascular leak syndrome, intravenous fluids should be administered with caution to prevent intra-abdominal hypertension and volume overload. Endoscopic retrograde cholangiopancreatography improves outcomes only in AP patients with suspected cholangitis. Early enteral tubefeeding does not appear to be superior to on-demand oral feeding. Abdominal compartment syndrome is a highly lethal complication of SAP that requires percutaneous drainage or decompressive laparotomy. Endoscopic transmural drainage followed by necrosectomy (i.e., "step-up approach") is the treatment strategy of choice in patients with symptomatic or infected walled-off pancreatic necrosis. Summary SAP is a complex clinical syndrome associated with a high mortality rate. Early prediction of SAP remains challenging due to the limited accuracy of the available prediction tools. Early fluid resuscitation, organ support, enteral nutrition, and prevention of/or prompt recognition of abdominal compartment syndrome remain cornerstones of its management. A step-up, minimally invasive drainage/debridement is the preferred approach for patients with infected pancreatic necrosis.

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Role of gut microbiota on intestinal barrier function in acute pancreatitis

Cited by 148 publications

References 45 publications

A narrative review of acute pancreatitis and its diagnosis, pathogenetic mechanism, and management

A narrative review of acute pancreatitis and its diagnosis, pathogenetic mechanism, and management

Microbiota and their Influence in the Human Body

Management of Severe Acute Pancreatitis

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