Signoretti Marianna, Roggiolani Roberta, Stornello Caterina, Delle Fave Gianfranco, Capurso Gabriele
Digestive and Liver Disease Unit, S. Andrea Hospital, Sapienza University, Rome, Italy.
Digestive and Liver Disease Unit, S. Andrea Hospital, Sapienza University, Rome, Italy -
Minerva Gastroenterol Dietol. 2017 Dec;63(4):399-410. doi: 10.23736/S1121-421X.17.02387-X. Epub 2017 Feb 24.
Changes in diet, lifestyle, and exposure to environmental risk factors account for the increased incidence of pancreatic disorders, including acute and chronic pancreatitis, and pancreatic cancer. The role of the microbiota in the development of pancreatic disorders is increasingly acknowledged. The translocation of gut bacteria and endotoxins following gut barrier failure is a key event contributing to the severity of acute pancreatitis, while small intestine bacterial overgrowth is common in patients with chronic pancreatitis and further worsens their symptoms and malnutrition. Specific molecular mimicry link the microbiota and Helicobacter pylori with autoimmune pancreatitis. Changes in the oral microbiota typical of periodontitis seem to be associated with an increased risk of developing pancreatic cancer. The composition of the gut microbiota is also unbalanced in the presence of risk factors for pancreatic cancer, such as obesity, smoking and diabetes. Helicobacter pylori infection, atrophic body gastritis and related decreased gastric acid secretion also seem associated with the risk of pancreatic cancer, although this area needs further research. The link between dysbiosis, immune response and proinflammatory status is most likely the key for these associations. The present review article will discuss current available evidence on the role of gut microbiota in pancreatic disorders, highlighting potential areas for future research.
饮食、生活方式的改变以及环境风险因素的暴露导致胰腺疾病（包括急性和慢性胰腺炎以及胰腺癌）的发病率上升。微生物群在胰腺疾病发展中的作用日益受到认可。肠道屏障功能衰竭后肠道细菌和内毒素的易位是导致急性胰腺炎严重程度的关键事件，而小肠细菌过度生长在慢性胰腺炎患者中很常见，并会进一步加重其症状和营养不良。特定的分子模拟将微生物群和幽门螺杆菌与自身免疫性胰腺炎联系起来。牙周炎典型的口腔微生物群变化似乎与患胰腺癌风险增加有关。在存在胰腺癌风险因素（如肥胖、吸烟和糖尿病）的情况下，肠道微生物群的组成也会失衡。幽门螺杆菌感染、萎缩性胃炎以及相关的胃酸分泌减少似乎也与胰腺癌风险有关，尽管这一领域需要进一步研究。生态失调、免疫反应和促炎状态之间的联系很可能是这些关联的关键。本综述文章将讨论目前关于肠道微生物群在胰腺疾病中作用的现有证据，突出未来研究的潜在领域。
