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On-line Access: 2023-08-16

Received: 2023-01-31

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Journal of Zhejiang University SCIENCE B

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Impacts of pancreatic exocrine insufficiency on gut microbiota


Author(s):  Yulin GUO, Feng CAO, Fei LI

Affiliation(s):  Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China; more

Corresponding email(s):  feili36@ccmu.edu.cn

Key Words:  Pancreatic exocrine insufficiency; Gut microbiota; Gut microbiome; Pancreatic enzyme replacement therapy


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Yulin GUO, Feng CAO, Fei LI. Impacts of pancreatic exocrine insufficiency on gut microbiota[J]. Journal of Zhejiang University Science B,in press.Frontiers of Information Technology & Electronic Engineering,in press.https://doi.org/10.1631/jzus.B2300070

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Abstract: 
Pancreatic exocrine insufficiency (PEI) can be induced by various kinds of diseases, including chronic pancreatitis, acute pancreatitis, post-pancreatectomy, among others. 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 duoadenal 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 pancreatic exocrine insufficiency on the gut microbiota.

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