Liu Qiang, Ruan Kaiyi, An Zihui, Li Lingyun, Ding Cong, Xu Dongchao, Yang Jianfeng, Zhang Xiaofeng
Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou 310058, China.
Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou 310006, China.
Int J Biol Sci. 2025 Jan 20;21(3):1242-1258. doi: 10.7150/ijbs.108858. eCollection 2025.
Acute pancreatitis (AP) is characterized by autodigestion of the pancreas, and some patients may rapidly progress to systemic inflammation, pancreatic necrosis, and multi-organ failure. Numerous studies have detailed the bidirectional communication networks between the pancreas and the intestinal microbiota, as well as its metabolites. Such crosstalk affects the progression of AP and recovery through intestinal barrier disruption. Furthermore, advances in experimental research and clinical studies have indicated that gut microorganisms exhibit distinct alterations in response to different levels of severity and etiologies of AP. This information has greatly expanded our knowledge of the role of the gut microflora and microbial metabolites in the pathology of disease and has reinforced the basis of therapeutic approaches that target candidate intestinal microbiota. In this review, we aim to provide an overview of the composition and diversity of the gut microbial community, to highlight the candidate bacteria and microbiota-derived metabolites responsible for AP, and to elucidate their interactions with and regulation of immune-relevant receptors in intestinal epithelial cells (IECs) in the host. Future research should focus on identifying and characterizing AP-associated bacterial strains, elucidating their distinct pathogenic mechanisms across different etiologies and stages of AP, and leveraging these insights to develop preventive and therapeutic strategies.
急性胰腺炎（AP）的特征是胰腺自身消化，部分患者可能迅速进展为全身炎症、胰腺坏死和多器官功能衰竭。众多研究详细阐述了胰腺与肠道微生物群及其代谢产物之间的双向通讯网络。这种相互作用通过破坏肠道屏障影响急性胰腺炎的进展和恢复。此外，实验研究和临床研究的进展表明，肠道微生物对不同严重程度和病因的急性胰腺炎会表现出不同的变化。这些信息极大地扩展了我们对肠道微生物群和微生物代谢产物在疾病病理中作用的认识，并加强了针对候选肠道微生物群的治疗方法的基础。在本综述中，我们旨在概述肠道微生物群落的组成和多样性，突出与急性胰腺炎相关的候选细菌和微生物群衍生代谢产物，并阐明它们与宿主肠道上皮细胞（IEC）中免疫相关受体的相互作用及其对这些受体的调节。未来的研究应集中于鉴定和表征与急性胰腺炎相关的细菌菌株，阐明它们在急性胰腺炎不同病因和阶段的独特致病机制，并利用这些见解制定预防和治疗策略。
