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©The Author(s) 2021.
World J Gastroenterol. Aug 14, 2021; 27(30): 5019-5036
Published online Aug 14, 2021. doi: 10.3748/wjg.v27.i30.5019
Published online Aug 14, 2021. doi: 10.3748/wjg.v27.i30.5019
Table 1 Revised Atlanta classification and determinant-based classification of acute pancreatitis
Revised Atlanta classification of disease severity | |
Mild AP | No organ failure |
No local or systemic complications | |
Moderately severe AP | Organ failure that resolved within 48 h (transient organ failure) and /or |
Local or systemic complications without persistent organ failure | |
Severe AP | Persistent organ failure > 48 h |
Single organ failure | |
Multiple organ failure | |
A modified Marshal score defines a persistent organ failure | |
Determinant-based classification of disease severity | |
RACAP | DBCAPS |
Mild AP | Mild AP |
Absence of organ failure | Absence of organ failure |
Absence of local complications | Absence of (peri-) pancreatic necrosis |
Moderately severe AP | Moderate AP |
Local complications and/or | Sterile (peri-) pancreatic necrosis and/or |
Transient organ failure | Transient organ failure |
Severe AP | Severe AP |
Persistent organ failure | Persistent organ failure or |
Infected (peri-) pancreatic necrosis | |
Critical AP persistent organ failure | |
Infected (peri-) pancreatic necrosis |
Table 2 Prediction scoring systems used in acute pancreatitis diagnosis
No. | Multifactorial scoring system | Timeline | Threshold | Area under the curve | Ref. |
1 | Ranson score | 48 h | ≥ 3 | 0.81–0.88 | [33-35] |
2 | Glasgow score | 48 h | 2 | 0.73–0.784 | [36,37] |
3 | Acute Physiology and Chronic Health Evaluation-II score (APACHE-II) | 24 h | 7 | 0.80–0.895 | [33,38,39] |
4 | Acute Physiology and Chronic Health Evaluation II score-Obesity (APACHE:-O) | 24 h | 7 | 0.893 | [40] |
5 | Bedside Index of Severity score (BISAP) | 24 h | ≥ 3 | 0.79–0.875 | [33-35,41] |
6 | Pancreatitis Activity Scoring System (PASS) | 24 h | > 160 | 0.71 | [36] |
7 | Systemic inflammatory response syndrome (SIRS) | 24 h | ≥ 2 | 0.73 | [34,39] |
Table 3 Blood biomarkers predicting disease severity in acute pancreatitis
No. | Blood biomarkers | Timeline | Threshold | Area under the curve | Ref. |
1 | Interleukin 8 | Preoperative | 196 pg/mL | 0.778 | [42] |
2 | Interleukin 6 | 24 h | 50 pg/mL | 0.9 | [39] |
3 | Hepcidin | 24 h | 234.4 ng/mL | 0.82 | [43] |
4 | Red blood cell distribution width | 24 h | 13.35% | 0.787 | [44] |
5 | Procalcitonin | 24 h | 1.77 ng/mL | 0.797 | [45] |
6 | Blood urea nitrogen | 24 h | 5.945 mg/dL | 0.677 | [44] |
7 | Oleic acid chlorohydrin | 24 h | 32.40 nM | 1 | [46] |
8 | C-reactive protein | 24 h | 150 mg/L | 0.61 | [47] |
9 | C-reactive protein | 48 h | 150 mg/L | 0.73–0.91 | [33,39,47] |
Table 4 MicroRNAs used as biomarkers in the diagnosis of acute pancreatitis
No. | miRNAs | Patients | Sample | Expression change | Reference gene | Ref. |
1 | miR-216a | AP | Plasma | Up | None | [49] |
2 | miR-551b-5p | AP | Plasma | Up | miR-16 | [50] |
3 | miR-216a-5p, miR-375, and miR-551b-5p | AP | Serum | Up | miR-103a-3p | [51] |
4 | miR-7, miR-9, miR-122, and miR-141 | AP | Serum | Up | Exogenous reference genes | [52] |
5 | miR-216a | AP | Plasma | Up | U6 | [53] |
6 | miR-551-5p | AP | PBMC- | Up | U6 | [54] |
7 | miR-155 | AP | Serum | Up | U6 | [55] |
8 | miR-29a | AP | Plasma | Up | U6 | [56] |
9 | miR-24-3p, miR-222-3p, miR-361-5p, and miR-1246 | HTG-AP | Serum | Up | U6 | [57] |
10 | miR-1260b, miR-762, miR-22-3p, miR-23b, and miR-23a | AP-associated ALI | Serum | Up | U6 | [58] |
11 | miR-92b, miR-10a, and miR-7 | AP | Plasma | Down | miR-16 | [50] |
12 | miR-155 | AP | Serum | Down | Not mentioned | [59] |
13 | miR-181a-5p | HTG-AP | Serum | Down | U6 | [57] |
14 | miR-550a, miR-324-5p, miR-484, miR-331-3p, miR-140-3p, miR-342-3p, and miR-150 | AP-associated ALI | Serum | Down | U6 | [58] |
15 | miR-127 | AP-associated ALI | Plasma | Down | miR-16 | [60] |
Table 5 Altered microbiome composition in acute pancreatitis vs healthy controls
No. | Techniques used for microbiome profiling | Healthy control | Acute pancreatitis | Ref. |
1 | qPCR (Fecal samples) | Firmicutes↑ | Firmicutes↓ | [84] |
Bacteroidetes↓ | Bacteroidetes↑ | |||
Proteobacteria↓ | Proteobacteria↑ | |||
Actinobacteria↑ | Actinobacteria↓ | |||
Tenericutes↓ | Tenericutes↑ | |||
2 | 16S rRNA gene sequencing (Fecal samples) | Proteobacteria↓ | Bacteroidetes↓ | [83] |
Proteobacteria↑ | ||||
Escherichia/Shigella↑ | ||||
Enterococcus↑ | ||||
Enterobacteriaceae↑ | ||||
Prevotella↓ | ||||
Faecalibacterium↓ | ||||
Bifidobacterium↓ | ||||
3 | 16S rRNA gene sequencing (Fecal samples) | NA | Bacteroidetes↑ | [85] |
Proteobacteria↑ | ||||
Firmicutes↓ | ||||
Actinobacteria↓ | ||||
4 | 16S rRNA gene sequencing (Fecal samples) | NA | Enterobacteriaceae↑ | [21] |
Enterococcus↑ | ||||
Bifidobacteria↓ |
Table 6 Altered microbiome composition observed in acute pancreatitis of increasing severity
No. | Techniques used for microbiome profiling | MAP | MSAP | SAP | Ref. |
1 | qPCR (Fecal samples), performed only on MAP and SAP patients | Enterococcus↑ | NA | Enterococcus↑ | [79] |
Enterobacteriaceae↑ | Enterobacteriaceae↑ | ||||
Bifidobacterium↓ | Bifidobacterium↓ | ||||
2 | 16S rRNA gene sequencing (Fecal samples) | Finegoldia↑ | NA | Acinetobacter↑ | [83] |
Stentrophomonas↑ | |||||
Geobacillus↑ | |||||
Bacteroides↓ | |||||
Alloprevotella↓ | |||||
Blautia↓ | |||||
Gemella↓ | |||||
3 | 16S rRNA sequencing (Fecal sample) | Enterobacteriaceae↑ | NA | Enterobacteriaceae↑ | [85] |
Enterococcus↑ | Enterococcus↑ | ||||
Bifidobacterium↓ | Bifidobacterium↓ | ||||
Blautia↓ | |||||
4 | 16S rRNA gene sequencing (Rectal swab) | Bacteroides↑ | Bacteroides↑ | Bacteroides↑ | [82] |
Escherichia/Shigella↑ | Escherichia/Shigella↑ | Escherichia/Shigella↑ | |||
Enterococcus↑ | Enterococcus↑ | Enterococcus↑ | |||
Eubacterium hallii↓ | |||||
Finegoldia↑ | Anaerococcus↑ | Acinetobacter↓ | |||
Stenotrophomonas↓ | |||||
Blautia↓ | Eubacterium hallii↓ | Bacteroides↓ | |||
Blautia↓ | |||||
5 | Shotgun metagenomics (Fecal sample) | Thermoprotei↑ | Sulfolobus↑ | Sulfolobus↑ | [86] |
Crenarchaeota↑ | Methanobrevibacter ruminantium↑ | Methanomicrobiales - archaeon 53_19↑ | |||
Streptococcus↑ | Methanosarcina - Thermophila↑ | Enterococcus↑ | |||
Anaerostipes hadrus↓ | Anaerostipes hadrus↓ | Blautia↓ | |||
Escherichia coli↑ |
- Citation: Patel BK, Patel KH, Bhatia M, Iyer SG, Madhavan K, Moochhala SM. Gut microbiome in acute pancreatitis: A review based on current literature. World J Gastroenterol 2021; 27(30): 5019-5036
- URL: https://www.wjgnet.com/1007-9327/full/v27/i30/5019.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i30.5019