摘要
Pancreatic exocrine insufficiency(PEI)can be induced by various kinds of diseases,including chronic pancreatitis,acute pancreatitis,and post-pancreatectomy.The main pathogenetic mechanism of PEI involves the decline of trypsin synthesis,disorder of pancreatic fluid flow,and imbalance of secretion feedback.Animal studies have shown that PEI could induce gut bacterial overgrowth and dysbiosis,with the abundance of Lactobacillus and Bifidobacterium increasing the most,which could be partially reversed by pancreatic enzyme replacement therapy.Clinical studies have also confirmed the association between PEI and the dysbiosis of gut microbiota.Pancreatic exocrine secretions and changes in duodenal p H as well as bile salt malabsorption brought about by PEI may affect and shape the abundance and composition of gut microbiota.In turn,the gut microbiota may impact the pancreatic exocrine acinus through potential bidirectional crosstalk.Going forward,more and higher-quality studies are needed that focus on the mechanism underlying the impact of PEI on the gut microbiota.
基金
supported by the Construction Project of Clinical Advanced Subjects of Capital Medical University(No.1192070312)
the Beijing Municipal Science&Technology Commission(Nos.Z171100001017077 and Z191100006619038)
the Capital Health Research and Development of Special(No.2020-1-2012)
the Capital Medical University Youth Science Foundation(No.PTZ21035),China。
作者简介
Fei LI,feili36@ccmu.edu.cn,https://orcid.org/0000-0002-0532-9054。
