Department of General Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, 116011, PR China; Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, 116044, PR China.
Orthopedic Research Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, 116001, PR China.
Biomed Pharmacother. 2020 Dec;132:110770. doi: 10.1016/j.biopha.2020.110770. Epub 2020 Oct 2.
Severe acute pancreatitis (SAP), a serious inflammatory disease of the pancreas, can easily lead to systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndromes (MODS). Acute lung injury (ALI) is one of the most serious complications of SAP. However, the specific pathogenesis of SAP-associated ALI is not fully understood. Crosstalk and multi-mechanisms involving pancreatic necrosis, bacteremia, intestinal barrier failure, activation of inflammatory cascades and diffuse alveolar damage is the main reason for the unclear pathological mechanism of SAP-associated ALI. According to previous research on SAP-associated ALI in our laboratory and theories put forward by other scholars, we propose that the complex pattern of SAP-associated ALI is based on the "pancreas-intestine-inflammation/endotoxin-lung (P-I-I/E-L) pathway". In this review, we mainly concentrated on the specific details of the "P-I-I/E-L pathway" and the potential treatments or preventive measures for SAP-associated ALI.
重症急性胰腺炎（SAP）是一种严重的胰腺炎症性疾病，容易引发全身炎症反应综合征（SIRS）和多器官功能障碍综合征（MODS）。急性肺损伤（ALI）是 SAP 的最严重并发症之一。然而，SAP 相关 ALI 的具体发病机制尚不完全清楚。涉及胰腺坏死、菌血症、肠道屏障功能衰竭、炎症级联激活和弥漫性肺泡损伤的相互作用和多机制是 SAP 相关 ALI 病理机制不明确的主要原因。根据我们实验室之前对 SAP 相关 ALI 的研究和其他学者提出的理论，我们提出 SAP 相关 ALI 的复杂模式是基于“胰腺-肠道-炎症/内毒素-肺（P-I-I/E-L）途径”。在这篇综述中，我们主要集中在“P-I-I/E-L 途径”的具体细节以及 SAP 相关 ALI 的潜在治疗或预防措施上。
