Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 14, 2021; 27(30): 5019-5036
Published online Aug 14, 2021. doi: 10.3748/wjg.v27.i30.5019
Gut microbiome in acute pancreatitis: A review based on current literature
Bharati Kadamb Patel, Kadamb H Patel, Madhav Bhatia, Shridhar Ganpati Iyer, Krishnakumar Madhavan, Shabbir M Moochhala
Bharati Kadamb Patel, Department of Surgery, National University of Singapore, Singapore 119228, Singapore
Kadamb H Patel, School of Applied Sciences, Temasek Polytechnic, Singapore 529757, Singapore
Madhav Bhatia, Department of Pathology, University of Otago, Christchurch 8140, New Zealand
Shridhar Ganpati Iyer, Krishnakumar Madhavan, Shabbir M Moochhala, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
Shridhar Ganpati Iyer, Krishnakumar Madhavan, National University Hospital, National University of Singapore, Singapore 119228, Singapore
Shabbir M Moochhala, Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
Author contributions: Patel BK and Patel KH drafted the manuscript and designed both of the figures; Bhatia M introduced the concept of the microbiome in acute pancreatitis; Iyer SG and Madhavan KK provided the clinical aspects of acute pancreatitis and microbiome in the manuscript; Moochhala SM conceptualized the manuscript, performed the literature search, and finalized the manuscript; all of the authors approved the final draft of this review.
Supported by Lee Foundation Microbiome Education Grant, No. N:176-000-054-001.
Conflict-of-interest statement: The authors declare having no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shabbir M Moochhala, MD, Associate Professor, Department of Surgery, National University of Singapore, NUHS Tower Block, Level 8, 1 E Lower Kent Ridge Road, Singapore 119228, Singapore. phcsmm@nus.edu.sg
Received: April 12, 2021
Peer-review started: April 12, 2021
First decision: May 24, 2021
Revised: June 4, 2021
Accepted: June 23, 2021
Article in press: June 23, 2021
Published online: August 14, 2021
Abstract

The gut microbiome is a complex microbial community, recognized for its potential role in physiology, health, and disease. The available evidence supports the role of gut dysbiosis in pancreatic disorders, including acute pancreatitis (AP). In AP, the presence of gut barrier damage resulting in increased mucosal permeability may lead to translocation of intestinal bacteria, necrosis of pancreatic and peripancreatic tissue, and infection, often accompanied by multiple organ dysfunction syndrome. Preserving gut microbial homeostasis may reduce the systemic effects of AP. A growing body of evidence suggests the possible involvement of the gut microbiome in various pancreatic diseases, including AP. This review discusses the possible role of the gut microbiome in AP. It highlights AP treatment and supplementation with prebiotics, synbiotics, and probiotics to maintain gastrointestinal microbial balance and effectively reduce hospitalization, morbidity and mortality in an early phase. It also addresses novel therapeutic areas in the gut microbiome, personalized treatment, and provides a roadmap of human microbial contributions to AP that have potential clinical benefit.

Keywords: Acute pancreatitis, Gut microbiota, Biomarkers, Diagnostics, Dysbiosis

Core Tip: We live in a world of microbes. There is a distinct microbiome sighted in every niche of our body. This review is based on current knowledge to define an overview of how the gut microbiota has accelerated the frontiers of understanding recently and empowered its importance in influencing human physiology through its potential role in various diseases. It further explores the possible application of microbiota-targeted therapeutics in routine clinical practice, meaning manipulating gut microbiota into the current therapeutics to minimize the potential risk of various diseases, including acute pancreatitis.