Targeting the gut microbiome dynamics and treatment strategies in acute pancreatitis

Background

Acute pancreatitis (AP) is a severe inflammatory condition characterized by sudden abdominal pain that may escalate to systemic inflammation and organ failure. Alterations in the gut microbiome, including overgrowth of pathogenic bacteria like Enterobacteriaceae and reduced levels of Bifidobacterium, have been linked to increased oxidative stress, bacterial translocation, and compromised intestinal barrier function, exacerbating systemic inflammation and disease severity. Recent research highlights the potential of phytoconstituents and microbiome modulation in regulating AP-associated inflammatory pathways.

Objective

This review examines the roles of the gut microbiome and phytochemicals in AP regulation and evaluates the impact of nutritional interventions, probiotics, and Ringer's lactate solution on AP management.

Method

A comprehensive literature search was conducted across multiple databases for studies published in English up to October 2024, using keywords like 'acute pancreatitis', 'gut microbiome', 'phytochemicals', and 'nutritional management'.

Results

Key phytochemicals, such as Quercetin, Rhein, and Kaempferol, effectively regulate lipase and amylase levels in AP patients. Controlled trials indicated that nutritional regulation and nano-curcumin supplementation significantly alleviated pain and improved clinical outcomes. The gut microbiome also modulated critical metabolic pathways related to AP, influencing inflammation and disease progression.

Conclusion

The gut microbiome significantly impacts pancreatic inflammation, enzyme regulation, and AP progression. Addressing oxidative stress and gut dysbiosis through phytomedicines, microbiome-targeted therapies, and nutritional strategies presents promising avenues for AP management. Further research is necessary to elucidate these interventions' mechanisms and potential clinical applications.