Altered gut microbiota in the early stage of acute pancreatitis were related to the occurrence of acute respiratory distress syndrome

Abstract

BackgroundAcute respiratory distress syndrome (ARDS) is the most common cause of organ failure in acute pancreatitis (AP) patients, which associated with high mortality. Specific changes in the gut microbiota have been shown to influence progression of acute pancreatitis. We aimed to determine whether early alterations in the gut microbiota is related to and could predict ARDS occurrence in AP patients.MethodsIn this study, we performed 16S rRNA sequencing analysis in 65 AP patients and 20 healthy volunteers. The AP patients were further divided into two groups: 26 AP-ARDS patients and 39 AP-nonARDS patients based on ARDS occurrence during hospitalization.ResultsOur results showed that the AP-ARDS patients exhibited specific changes in gut microbiota composition and function as compared to subjects of AP-nonARDS group. Higher abundances of Proteobacteria phylum, Enterobacteriaceae family, Escherichia-Shigella genus, and Klebsiella pneumoniae, but lower abundances of Bifidobacterium genus were found in AP-ARDS group compared with AP-nonARDS groups. Random forest modelling analysis revealed that the Escherichia-shigella genus was effective to distinguish AP-ARDS from AP-nonARDS, which could predict ARDS occurrence in AP patients.ConclusionsOur study revealed that alterations of gut microbiota in AP patients on admission were associated with ARDS occurrence after hospitalization, indicating a potential predictive and pathogenic role of gut microbiota in the development of ARDS in AP patients.

Exploring the Microbial Landscape: Gut Dysbiosis and Therapeutic Strategies in Pancreatitis—A Narrative Review

“…By affecting the microcirculation at the intestinal level, followed by a decrease in tissue perfusion, the integrity of the intestinal barrier is altered [ 29 ]. Numerous studies have demonstrated that intestinal permeability increases shortly after the onset of pancreatitis, a process followed by the translocation of bacteria to other locations ( Figure 1 ) [ 31 , 32 ].…”

“…Selected studies ( Table 1 ) reported changes in the intestinal microbiota since the onset of acute pancreatitis, describing a decrease in bacterial diversity, with an increase at the phylum level in potentially pathogenic bacteria such as Bacteroidetes and Proteobacteria compared to healthy controls [ 32 , 37 , 38 , 39 , 40 ]. At the family level, Enterococcaceae , Enterobacteriaceae , and Bacteroidaceae increased, while at the genus level, Bacteroides , Enterococcus , and Escherichia–Shigella were more abundant in patients with AP [ 32 , 40 , 41 ].…”

“…Selected studies ( Table 1 ) reported changes in the intestinal microbiota since the onset of acute pancreatitis, describing a decrease in bacterial diversity, with an increase at the phylum level in potentially pathogenic bacteria such as Bacteroidetes and Proteobacteria compared to healthy controls [ 32 , 37 , 38 , 39 , 40 ]. At the family level, Enterococcaceae , Enterobacteriaceae , and Bacteroidaceae increased, while at the genus level, Bacteroides , Enterococcus , and Escherichia–Shigella were more abundant in patients with AP [ 32 , 40 , 41 ]. A decrease at the phylum level in Firmicutes and Actinobacteria was reported [ 38 ], while at the genus level, a decrease in Bifidobacterium and Blautia was observed [ 32 , 40 , 41 ]; at the family level, a decrease in Ruminococcaceae in patients with AP versus healthy controls was observed [ 32 ].…”

“…At the family level, Enterococcaceae , Enterobacteriaceae , and Bacteroidaceae increased, while at the genus level, Bacteroides , Enterococcus , and Escherichia–Shigella were more abundant in patients with AP [ 32 , 40 , 41 ]. A decrease at the phylum level in Firmicutes and Actinobacteria was reported [ 38 ], while at the genus level, a decrease in Bifidobacterium and Blautia was observed [ 32 , 40 , 41 ]; at the family level, a decrease in Ruminococcaceae in patients with AP versus healthy controls was observed [ 32 ].…”

“…Multiple studies have shown that these bacterial alterations are positively correlated with disease severity [ 37 , 40 , 41 , 42 ]. Hu et al reported that the abundance of Enterococcaceae and Enterobacteriaceae increased with disease progression [ 32 ], while Yu et al and Zhu et al observed that the dominant species varied according to the degree of disease severity, with Bacteroides being abundant in the mild form, and Escherichia–Shigella in the moderate–severe form, while Enterococcus was more predominant in the severe form [ 37 , 45 ]. Proteobacteria was also found to be significantly increased with disease severity, with research demonstrating Proteobacteria overgrowth in patients with AP, particularly SAP [ 37 , 40 , 45 ].…”