胰腺外分泌功能不全对肠道微生物群的影响

郭玉霖; 曹锋; 李非

doi:10.1631/jzus.B2300070

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Review | Updated：2024-04-07

胰腺外分泌功能不全对肠道微生物群的影响
Impacts of pancreatic exocrine insufficiency on gut microbiota
浙江大学学报（英文版）（B辑：生物医学和生物技术） 2024年25卷第4期页码：271-279
Affiliations：

1.Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China
2.Acute Pancreatitis Clinical Center of Capital Medical University, Beijing 100053, China
Funds：

the Construction Project of Clinical Advanced Subjects of Capital Medical University(1192070312);the Beijing Municipal Science & Technology Commission(Z171100001017077;Z191100006619038);the Capital Health Research and Development of Special(2020-1-2012);the Capital Medical University Youth Science Foundation(PTZ21035)
DOI：10.1631/jzus.B2300070
中图分类号：
CSTR：
纸质出版日期： 2024-04-15 ，

收稿日期： 2023-01-31 ，

修回日期： 2023-07-29 ，

郭玉霖,曹锋,李非.胰腺外分泌功能不全对肠道微生物群的影响[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2024,25(04):271-279.

Yulin GUO, Feng CAO, Fei LI. Impacts of pancreatic exocrine insufficiency on gut microbiota[J]. Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2024,25(4):271-279.
郭玉霖,曹锋,李非.胰腺外分泌功能不全对肠道微生物群的影响[J].浙江大学学报（英文版）（B辑：生物医学和生物技术）,2024,25(04):271-279. DOI： 10.1631/jzus.B2300070.

Yulin GUO, Feng CAO, Fei LI. Impacts of pancreatic exocrine insufficiency on gut microbiota[J]. Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2024,25(4):271-279. DOI： 10.1631/jzus.B2300070.

摘要

胰腺外分泌功能不全（PEI）可由多种疾病引起，包括慢性胰腺炎、急性胰腺炎、胰腺切除术后等。PEI其主要发病机制与胰蛋白酶合成下降、胰液流动紊乱、分泌反馈失衡有关。动物研究表明：PEI可诱导肠道细菌过度生长和生态失调，其中乳杆菌和双歧杆菌的丰度增加最为多见；肠道细菌过度生长和生态失调可通过胰酶替代治疗得到部分逆转。临床研究也证实PEI与肠道菌群失调之间存在关联。胰脏外分泌水平的下降，伴随PEI产生的十二指肠pH值的改变，以及PEI引起的胆盐吸收不良，这可能是PEI导致肠道菌群丰度和组成发生改变的潜在作用机制。反之，肠道微生物群也可能通过潜在的双向调节影响胰腺外分泌腺泡的功能。展望未来，仍需要更多的高质量研究来揭示胰腺外分泌不足对肠道微生物群影响的机制。

Abstract

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 pH 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.

关键词

胰腺外分泌不足肠道微生物群肠道微生物组胰酶替代疗法

Keywords

Pancreatic exocrine insufficiencyGut microbiotaGut microbiomePancreatic enzyme replacement therapy

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