Gastrointestinal microecology: a crucial and potential target in acute pancreatitis

In the early stage of acute pancreatitis (AP), abundant cytokines induced by local pancreatic inflammation enter the bloodstream, further cause systemic inflammatory response syndrome (SIRS) by “trigger effect”, which eventually leads to multiple organ dysfunction syndrome (MODS). During SIRS and MO...

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Published inApoptosis (London) Vol. 23; no. 7-8; pp. 377 - 387
Main Authors Cen, Meng-Er, Wang, Feng, Su, Ying, Zhang, Wang-Jun, Sun, Bei, Wang, Gang
Format Journal Article
LanguageEnglish
Published New York Springer US 01.08.2018
Springer
Springer Nature B.V
Subjects
Biochemistry
Biomedical and Life Sciences
Biomedicine
Cancer Research
Cell Biology
Cytokines
Digestive system
Disseminated infection
Dysbacteriosis
Gastrointestinal tract
Health aspects
Infection
Infections
Inflammation
Inflammatory response
Intestine
Microbiota (Symbiotic organisms)
Microflora
Multiple organ dysfunction syndrome
Oncology
Pancreas
Pancreatitis
Review
Small intestine
Systemic inflammatory response syndrome
Therapeutic applications
Virology
Intestinal barrier
Acute pancreatitis
Gastrointestinal microecology
Systemic inflammatory response syndrome
Enteral nutrition
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Summary:In the early stage of acute pancreatitis (AP), abundant cytokines induced by local pancreatic inflammation enter the bloodstream, further cause systemic inflammatory response syndrome (SIRS) by “trigger effect”, which eventually leads to multiple organ dysfunction syndrome (MODS). During SIRS and MODS, the intestinal barrier function was seriously damaged accompanied by the occurrence of gut-derived infection which forms a “second hit summit” by inflammatory overabundance. Gastrointestinal microecology, namely the biologic barrier, could be transformed into a pathogenic state, which is called microflora dysbiosis when interfered by the inflammatory stress during AP. More and more evidences indicate that gastrointestinal microflora dysbiosis plays a key role in “the second hit” induced by AP gut-derived infection. Therefore, the maintenance of gastrointestinal microecology balance is likely to provide an effective method in modulating systemic infection of AP. This article reviewed the progress of gastrointestinal microecology in AP to provide a reference for deeply understanding the pathogenic mechanisms of AP and identifying new therapeutic targets.
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ISSN:1360-8185
1573-675X
DOI:10.1007/s10495-018-1464-9