欢迎来到OAJRC平台！

期刊栏目

投稿

审稿

期刊目次

加入编委

期刊订阅

添加您的邮件地址以接收即将发行期刊数据：

当前位置：国际临床研究杂志 > 2022年 6卷 (7)期

Open Access Article

International Journal of Clinical Research. 2022; 6: (7) ; 16-22 ; DOI: 10.12208/j.ijcr.20220297.

Research Progress on the relationship between Intestinal flora and Acute pancreatitis
肠道菌群与急性胰腺炎相关性研究进展

作者： 梁国强, 朱慧, 章一凡 *

南京中医药大学附属苏州市中医医院中心实验室江苏苏州

南京中医药大学附属苏州市中医医院脾胃病科江苏苏州

*通讯作者：章一凡,单位：南京中医药大学附属苏州市中医医院脾胃病科江苏苏州；

苏州市临床重点病种诊疗技术专项江苏省名老中医药专家葛惠男传承工作室建设项目苏州市第九批姑苏卫生重点人才项目

发布时间: 2022-09-07 总浏览量: 515

PDF 全文下载引用本文收录截图（CNKI-Scholar）万方数据（WANFANG DATA）

摘要

急性胰腺炎（AP）是一种常见的胃肠道疾病。大约 15%-20% 的患者发展为严重的 AP。全身炎症反应综合征和多器官功能障碍综合征可能是由于重症AP早期大量释放炎性细胞因子，后期出现肠功能障碍和胰腺坏死。当前研究表明，59%的AP患者伴有肠屏障损伤，肠黏膜通透性增加，导致肠道细菌易位、胰腺组织坏死和感染，并发生多器官功能障碍综合征。关于 AP 的病理生理学、治疗选择和临床试验有相关综述报道。然而，肠道微生物群及其代谢物对 AP 肠道屏障功能的真正影响仍不清楚。本综述总结了AP发展和进展过程中肠道菌群及其代谢物的变化，以揭示AP肠道衰竭的机制。

关键词： 肠道菌群；急性胰腺炎；相关性研究

Abstract

Acute pancreatitis (AP) is a common gastrointestinal disorder. Approximately 15%-20% of patients develop severe AP. Systemic inflammatory response syndrome and multiple organ dysfunction syndrome may be caused by the massive release of inflammatory cytokines in the early stage of severe AP, followed by intestinal dysfunction and pancreatic necrosis in the later stage. Current study showed that 59% of AP patients had associated intestinal barrier injury, with increased intestinal mucosal permeability, leading to intestinal bacterial translocation, pancreatic tissue necrosis and infection, and the occurrence of multiple organ dysfunction syndrome. There are several reviews on the pathophysiology, therapeutic options and clinical trials of AP. However, the real effect of the gut microbiota and its metabolites on intestinal barrier function in AP remains unclear. This review summarizes the alterations in the intestinal flora and its metabolites during AP development and progression to unveil the mechanism of gut failure in AP.

Key words： Intestinal flora; Acute pancreatitis; Correlation study

参考文献 References

[1] Bäckhed F, Ley RE, Sonnenburg JL, et al. Host-bacterial mutualism in the human intestine[J]. Science, 2005, 307 (5717):1915-1920.

[2] 张成岗. 将肠道"第二大脑"即"菌脑"视为人体解剖结构与功能组成的一部分的必要性[J]. 解剖学杂志, 2021(S01):17-17.

[3] Lucas López R, Grande Burgos MJ, Gálvez A, et al. The human gastrointestinal tract and oral microbiota in inflammatory bowel disease: a state of the science review[J]. APMIS, 2017,125(1):3-10.

[4] Schmitt F, Brenner T, Uhle F, et al. Gut microbiome patterns correlate with higher postoperative complication rates after pancreatic surgery[J]. BMC Microbiol, 2019,19(1):42.

[5] 李雪荣, 李晓丽. 肠道菌群与非消化系统疾病关系的研究进展[J]. 胃肠病学和肝病学杂志,2022,31(01):14-17.

[6] Wang Y, Yang G, You L, et al. Role of the microbiome in occurrence, development and treatment of pancreatic cancer[J]. Mol Cancer, 2019,18(1):173.

[7] Akshintala VS, Talukdar R, Singh VK, et al. The Gut Microbiome in Pancreatic Disease[J]. Clin Gastroenterol Hepatol, 2019,17(2):290-295.

[8] Tilg H, Adolph TE. Beyond Digestion: The Pancreas Shapes Intestinal Microbiota and Immunity[J]. Cell Metab, 2017,25(3):495-496.

[9] Silva-Vaz P, Abrantes AM, Castelo-Branco M, et al. Murine Models of Acute Pancreatitis: A Critical Appraisal of Clinical Relevance[J]. Int J Mol Sci, 2019,20(11).

[10] Zhu Y, He C, Li X, et al. Gut microbiota dysbiosis worsens the severity of acute pancreatitis in patients and mice[J]. J Gastroenterol, 2019,54(4):347-358.

[11] Borrello MT, Martin MB, Pin CL. The unfolded protein response: An emerging therapeutic target for pancreatitis and pancreatic ductal adenocarcinoma.Pancreatology. 2022;22(1):148-159.

[12] 焦芳芳, 张伟, 武云珍. 急重症胰腺炎合并肝损伤患者IL-10、TGFβ及其mRNA水平与肝功能指标的相关性[J]. 肝脏,2021,26(09):1027-1030.

[13] 王文明, 朱贞祥, 程桐花,等. 中性粒细胞比率联合乳酸脱氢酶对急性胰腺炎严重程度的早期预测价值[J]. 临床急诊杂志,2022,23(01):11-14.

[14] Silva-Vaz P, Abrantes AM, Castelo-Branco M, et al. Multifactorial Scores and Biomarkers of Prognosis of Acute Pancreatitis: Applications to Research and Practice[J]. Int J Mol Sci, 2020,21(1).

[15] 申鼎成, 黄耿文. 感染性胰腺坏死的诊治进展[J]. 中国普通外科杂志,2021,30(09):1006-1011.

[16] Banks P ,Bollen T , Dervenis C , et al. Acute Pancreatitis Classification Working Group. Classification of acute pancreatitis–2012: revision of the Atlanta classification and definitions by international consensus[J]. Gut, 2013, 62(1):102-11.

[17] Ammori, Basil J . Role of the gut in the course of severe acute pancreatitis.[J]. Pancreas, 2003, 26(2):122-129.

[18] Patel BK, Patel KH, Bhatia M, et al. Gut microbiome in acute pancreatitis: A review based on current literature[J]. World J Gastroenterol, 2021,27(30):5019-5036.

[19] Mikó A, Vigh É, Mátrai P, et al. Computed Tomography Severity Index vs. Other Indices in the Prediction of Severity and Mortality in Acute Pancreatitis: A Predictive Accuracy Meta-analysis[J]. Front Physiol, 2019,10:1002.

[20] Li M, Xing XK, Lu ZH, et al. Comparison of Scoring Systems in Predicting Severity and Prognosis of Hypertriglyceridemia-Induced Acute Pancreatitis[J]. Dig Dis Sci, 2020,65(4):1206-1211.

[21] Zhou H, Mei X, He X, et al. Severity stratification and prognostic prediction of patients with acute pancreatitis at early phase: A retrospective study[J]. Medicine (Baltimore), 2019, 98(16):e15275.

[22] Yang Y, Huang Q, Luo C, et al. MicroRNAs in acute pancreatitis: From pathogenesis to novel diagnosis and therapy[J]. J Cell Physiol, 2020,235(3):1948-1961.

[23] 甘宇, 李昕, 周文策. 消化道微生物与胰腺癌相关性研究[J]. 中国微生态学杂志,2022,34(02):246-249.

[24] 汪洪涛. 肠道微生物与人体健康的关系及其影响因素研究进展[J]. 食品安全质量检测学报,2022, 13(01): 175-181.

[25] 梁仙志, 廖旻晶, 王宏波,等. 肠道微生物群与部分人类疾病的研究进展[J]. 基因组学与应用生物学,2020, 39(12): 5874-5880.

[26] 袁方婷, 罗和生. 肠道微生物在消化系统疾病中的研究进展[J]. 医学综述,2019,25(24):4933-4939.

[27] Zhu Y, He C, Li X, et al. Gut microbiota dysbiosis worsens the severity of acute pancreatitis in patients and mice[J]. J Gastroenterol, 2019, 54(4):347-358.

[28] Cen ME, Wang F, Su Y, et al. Gastrointestinal microecology: a crucial and potential target in acute pancreatitis[J]. Apoptosis, 2018,23(7-8):377-387.

[29] 孙娜娜. 急性胰腺炎住院患者早期胃肠功能与疾病进展的相关性[J]. 中国实用医药,2021,16(03):61-63.

[30] Clemente Jose C, Julia M, Scher Jose U. The role of the gut microbiome in systemic inflammatory disease[J]. BMJ (Clinical research ed.), 2018,360(jan08 4).

[31] 陈莹, 侯亚义, 王婷婷. 肠道菌群对CD4+T淋巴细胞分化和稳态影响的研究进展[J]. 江苏大学学报(医学版),2020,30(05):376-385.

[32] 吴宪佳, 张克明. 胃肠道微生物与胰腺癌研究进展[J]. 中华肝胆外科杂志,2022,28(03):237-240.

[33] Li XY, He C, Zhu Y, et al. Role of gut microbiota on intestinal barrier function in acute pancreatitis[J]. World J Gastroenterol, 2020,26(18):2187-2193.

[34] Tilg H, Adolph TE. Beyond Digestion: The Pancreas Shapes Intestinal Microbiota and Immunity[J]. Cell Metab, 2017, 25(3):495-496.

[35] 殷诺铭, 曾悦. 重症急性胰腺炎中的肠道免疫与菌群紊乱[J]. 中华胰腺病杂志, 2021, 21(03):168-172.

[36] 王燕, 贡丽雅, 王凤姣,等. 益生菌联合肠内营养对结肠癌患者肠黏膜屏障功能及炎症反应的影响[J]. 中国医药导报,2019,16(14):101-103+108.

[37] 刘占举, 吴维, 邱骅婧,等. 肠黏膜组织内免疫系统调节异常参与炎症性肠病的发生[J]. 世界华人消化杂志,2013,21(07):567.

[38] Thomas RM, Jobin C. Microbiota in pancreatic health and disease: the next frontier in microbiome research[J]. Nat Rev Gastroenterol Hepatol, 2020,17(1):53-64.

[39] 李颖, 麻锦敏. 宏基因组学测序技术在中重症感染中的临床应用专家共识(第一版)[J]. 中华危重病急救医学,2020,32(05):531-536.

[40] 石春卫, 陈毅秋, 胡静涛,等. 肠道微生物群对宿主免疫系统发育和功能的调节[J]. 中国免疫学杂志,2016, 32(10): 1536-1540.

[41] 黄莹, 彭剑桥, 王宇鹏,等. 肠道菌群失衡与急性胰腺炎易位感染的关系[J]. 中国微生态学杂志,2019, 31(01): 17-20+24.

[42] Tsuji Y, Watanabe T, Kudo M, et al. Sensing of commensal organisms by the intracellular sensor NOD1 mediates experimental pancreatitis[J]. Immunity, 2012, 37(2): 326-338.

[43] van der Poll T, Shankar-Hari M, Wiersinga WJ. The immunology of sepsis[J]. Immunity, 2021, 54(11): 2450-2464.

[44] 魏肖,于红刚. 调整肠道微生物群治疗下消化道疾病的方法[J]. 医学综述,2020,26(12):2333-2337.

[45] Ahuja M, Schwartz DM, Tandon M, et al. Orai1-Mediated Antimicrobial Secretion from Pancreatic Acini Shapes the Gut Microbiome and Regulates Gut Innate Immunity[J]. Cell Metab, 2017,25(3):635-646.

[46] 郭易楠, 刘瑞霞, 阴赪宏. 肠道菌群在急性胰腺炎发生发展中的作用[J]. 中国医刊,2019,54(06):592-594.

[47] Petrov MS, Shanbhag S, Chakraborty M, et al. Organ failure and infection of pancreatic necrosis as determinants of mortality in patients with acute pancreatitis[J]. Gastroenterology, 2010,139(3):813-820.

[48] Tan C, Ling Z, Huang Y, et al. Dysbiosis of Intestinal Microbiota Associated With Inflammation Involved in the Progression of Acute Pancreatitis[J]. Pancreas, 2015, 44(6): 868-875.

[49] Gerritsen J, Timmerman HM, Fuentes S, et al. Correlation between protection against sepsis by probiotic therapy and stimulation of a novel bacterial phylotype[J]. Appl Environ Microbiol, 2011, 77(21):7749-7756.

[50] Rychter JW, van Minnen LP, Verheem A, et al. Pretreatment but not treatment with probiotics abolishes mouse intestinal barrier dysfunction in acute pancreatitis[J]. Surgery, 2009,145(2):157-167.

[51] Yu S, Xiong Y, Xu J, et al. Identification of Dysfunctional Gut Microbiota Through Rectal Swab in Patients with Different Severity of Acute Pancreatitis[J]. Dig Dis Sci, 2020,65(11):3223-3237.

[52] 罗旭颖, 王红. 重症急性胰腺炎中肠道免疫功能紊乱的研究进展[J]. 世界华人消化杂志,2009,17(02):169-173.

[53] 何荣香, 唐红艳, 杨玲,等. 短链脂肪酸在单胃动物肠道中的生理功能及其作用机制的研究进展[J]. 中国畜牧杂志,2020,56(04):1-5.

[54] Kelly CJ, Zheng L, Campbell EL, et al. Crosstalk between Microbiota-Derived Short-Chain Fatty Acids and Intestinal Epithelial HIF Augments Tissue Barrier Function[J]. Cell Host Microbe, 2015,17(5):662-671.

[55] Memba R, Duggan SN, Ni Chonchubhair HM, et al. The potential role of gut microbiota in pancreatic disease: A systematic review[J]. Pancreatology, 2017,17(6):867-874.

[56] Pan LL, Niu W, Fang X, et al. Clostridium butyricum Strains Suppress Experimental Acute Pancreatitis by Maintaining Intestinal Homeostasis[J]. Mol Nutr Food Res, 2019:e1801419.

[57] 谭超超,王衡新. 益生菌对大鼠急性胰腺炎肠道细菌易位感染的调控作用及机制[J]. 新疆医科大学学报,2021,44(08):897-901.

[58] Working Group IAP/APA Acute Pancreatitis Guidelines. IAP/APA evidence-based guidelines for the management of acute pancreatitis[J]. Pancreatology, 2013,13(4 Suppl 2):e1-15.

[59] 刘世洲, 田彦璋. 重症急性胰腺炎合并胰周感染性坏死外科治疗的研究进展[J]. 医学综述,2019,25(09): 1772- 1775+1781.

[60] Hegazi RA, DeWitt T. Enteral nutrition and immune modulation of acute pancreatitis[J]. World J Gastroenterol, 2014,20(43):16101-16105.

[61] 李雪洋, 祝荫. 肠道菌群失衡在急性胰腺炎肠黏膜屏障损伤中的作用[J]. 中国实用内科杂志,2021,41(01): 14-17.

[62] 臧凯丽, 江岩, 孙勇,等. 益生菌剂调整肠道疾病人群菌群结构丰度水平的研究[J]. 食品科学,2018, 39(13): 133-143.

[63] Pan LL, Li J, Shamoon M, et al. Recent Advances on Nutrition in Treatment of Acute Pancreatitis[J]. Front Immunol, 2017,8:762.

[64] Oláh A, Belágyi T, Pótó L, et al. Synbiotic control of inflammation and infection in severe acute pancreatitis: a prospective, randomized, double blind study[J]. Hepatogastroenterology, 2007,54(74):590-594.

[65] Mangiante G, Colucci G, Canepari P, et al. Lactobacillus plantarum reduces infection of pancreatic necrosis in experimental acute pancreatitis[J]. Dig Surg, 2001, 18(1): 47-50.

[66] Akyol S, Mas MR, Comert B, et al. The effect of antibiotic and probiotic combination therapy on secondary pancreatic infections and oxidative stress parameters in experimental acute necrotizing pancreatitis[J]. Pancreas, 2003,26(4):363-367.

[67] Muftuoglu MA, Isikgor S, Tosun S, et al. Effects of probiotics on the severity of experimental acute pancreatitis[J]. Eur J Clin Nutr, 2006,60(4):464-468.

[68] 田亚针, 张晨曦, 杨涛,等. 益生菌和粪菌移植调节炎症性肠病的研究进展[J]. 食品科学,2021,42(19):250-259.

[69] 赵美琪, 王婧, 崔乃玲,等. 短链脂肪酸与肠道疾病关系的研究进展[J]. 中国现代医药杂志,2020, 22(09): 105-108.

引用本文

梁国强, 朱慧, 章一凡, 肠道菌群与急性胰腺炎相关性研究进展[J]. 国际临床研究杂志, 2022; 6: (7) : 16-22.

入驻平台

回到首页

搜索文章: