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肠道微生物群与急性胰腺炎中的炎症反应相互作用。

Gut microbiota interacts with inflammatory responses in acute pancreatitis.

作者信息

Wu Linjun, Hu Jing, Yi Xiaolin, Lv Jianqin, Yao Jiaqi, Tang Wenfu, Zhang Shu, Wan Meihua

机构信息

Department of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, China.

Hospital of Chinese Traditional Medicine of Leshan, Leshan, China.

出版信息

Therap Adv Gastroenterol. 2023 Oct 10;16:17562848231202133. doi: 10.1177/17562848231202133. eCollection 2023.

Abstract

Acute pancreatitis (AP) is one of the most common acute abdominal conditions, and its incidence has been increasing for years. Approximately 15-20% of patients develop severe AP (SAP), which is complicated by critical inflammatory injury and intestinal dysfunction. AP-associated inflammation can lead to the gut barrier and function damage, causing dysbacteriosis and facilitating intestinal microbiota migration. Pancreatic exocrine deficiency and decreased levels of antimicrobial peptides in AP can also lead to abnormal growth of intestinal bacteria. Meanwhile, intestinal microbiota migration influences the pancreatic microenvironment and affects the severity of AP, which, in turn, exacerbates the systemic inflammatory response. Thus, the interaction between the gut microbiota (GM) and the inflammatory response may be a key pathogenic feature of SAP. Treating either of these factors or breaking their interaction may offer some benefits for SAP treatment. In this review, we discuss the mechanisms of interaction of the GM and inflammation in AP and factors that can deteriorate or even cure both, including some traditional Chinese medicine treatments, to provide new methods for studying AP pathogenesis and developing therapies.

摘要

急性胰腺炎(AP)是最常见的急性腹部疾病之一,其发病率多年来一直在上升。约15%-20%的患者会发展为重症急性胰腺炎(SAP),并伴有严重的炎症损伤和肠道功能障碍。AP相关的炎症可导致肠道屏障和功能受损,引起菌群失调并促进肠道微生物群迁移。AP患者的胰腺外分泌功能不足以及抗菌肽水平降低也可导致肠道细菌异常生长。同时,肠道微生物群迁移会影响胰腺微环境并影响AP的严重程度,进而加剧全身炎症反应。因此,肠道微生物群(GM)与炎症反应之间的相互作用可能是SAP的关键致病特征。针对这些因素之一进行治疗或打破它们之间的相互作用可能对SAP治疗有益。在这篇综述中,我们讨论了GM与AP炎症相互作用的机制以及可能使两者恶化甚至治愈的因素,包括一些中医治疗方法,以为研究AP发病机制和开发治疗方法提供新途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/545b/10566291/d7ae4e9ba25a/10.1177_17562848231202133-fig1.jpg

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