Prevalence of pancreatic exocrine insufficiency after pancreatic surgery measured by 13C mixed triglyceride breath test: A prospective cohort study

Hartman, V.; Roeyen, E.; Bracke, B.; Huysentruyt, Frederik; Gendt, S. De; Chapelle, T.; Ysebaert, Dirk; Hendrikx, Bart; Roeyen, Geert

doi:10.1016/j.pan.2023.05.012

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…A common feature of PDAC is pancreatic exocrine insufficiency (PEI), which is prevalent and progressive, particularly in those patients with tumours located in the head of the pancreas [ 113 , 114 ]. PEI is associated with poorer survival in PDAC and its treatment with pancreatic enzyme replacement therapy (PERT) improves survival almost as much as chemotherapy [ 115 ].…”

Section: Discussionmentioning

confidence: 99%

Involvement of the Gut Microbiome in the Local and Systemic Immune Response to Pancreatic Ductal Adenocarcinoma

Halle-Smith,

Pearce,

Nicol

et al. 2024

Cancers

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The systemic and local immunosuppression exhibited by pancreatic ductal adenocarcinoma (PDAC) contributes significantly to its aggressive nature. There is a need for a greater understanding of the mechanisms behind this profound immune evasion, which makes it one of the most challenging malignancies to treat and thus one of the leading causes of cancer death worldwide. The gut microbiome is now thought to be the largest immune organ in the body and has been shown to play an important role in multiple immune-mediated diseases. By summarizing the current literature, this review examines the mechanisms by which the gut microbiome may modulate the immune response to PDAC. Evidence suggests that the gut microbiome can alter immune cell populations both in the peripheral blood and within the tumour itself in PDAC patients. In addition, evidence suggests that the gut microbiome influences the composition of the PDAC tumour microbiome, which exerts a local effect on PDAC tumour immune infiltration. Put together, this promotes the gut microbiome as a promising route for future therapies to improve immune responses in PDAC patients.

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Section: Discussionmentioning

confidence: 99%

Involvement of the Gut Microbiome in the Local and Systemic Immune Response to Pancreatic Ductal Adenocarcinoma

Halle-Smith,

Pearce,

Nicol

et al. 2024

Cancers

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“…PEI has been shown to be both prevalent and progressive amongst patients with pancreatic cancer. A recent prospective cohort study used the 13 C mixed triglyceride breath test to investigate the prevalence of PEI amongst 254 patients awaiting pancreatoduodenectomy for an oncologic indication [41]. This study reported an incidence of 32.8% in those awaiting resection [41].…”

Section: Pancreatic Exocrine Insufficiency In Pancreatic Cancermentioning

confidence: 99%

“…A recent prospective cohort study used the 13 C mixed triglyceride breath test to investigate the prevalence of PEI amongst 254 patients awaiting pancreatoduodenectomy for an oncologic indication [41]. This study reported an incidence of 32.8% in those awaiting resection [41]. In addition, a systematic review in 2016 identified four studies evaluating PEI preoperatively, all using faecal elastase (FE-1), and found a median prevalence of 44% (range 42-47%) [42].…”

Section: Pancreatic Exocrine Insufficiency In Pancreatic Cancermentioning

confidence: 99%

Pancreatic Exocrine Insufficiency and the Gut Microbiome in Pancreatic Cancer: A Target for Future Diagnostic Tests and Therapies?

Halle-Smith,

Hall,

Powell-Brett

et al. 2023

Cancers

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Pancreatic exocrine insufficiency (PEI) is common amongst pancreatic cancer patients and is associated with poorer treatment outcomes. Pancreatic enzyme replacement therapy (PERT) is known to improve outcomes in pancreatic cancer, but the mechanisms are not fully understood. The aim of this narrative literature review is to summarise the current evidence linking PEI with microbiome dysbiosis, assess how microbiome composition may be impacted by PERT treatment, and look towards possible future diagnostic and therapeutic targets in this area. Early evidence in the literature reveals that there are complex mechanisms by which pancreatic secretions modulate the gut microbiome, so when these are disturbed, as in PEI, gut microbiome dysbiosis occurs. PERT has been shown to return the gut microbiome towards normal, so called rebiosis, in animal studies. Gut microbiome dysbiosis has multiple downstream effects in pancreatic cancer such as modulation of the immune response and the response to chemotherapeutic agents. It therefore represents a possible future target for future therapies. In conclusion, it is likely that the gut microbiome of pancreatic cancer patients with PEI exhibits dysbiosis and that this may potentially be reversible with PERT. However, further human studies are required to determine if this is indeed the case.

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Comprehensive, long-term evaluation of pancreatic exocrine insufficiency after pancreatoduodenectomy

Powell-Brett,

Halle-Smith,

Hall

et al. 2024

Pancreatology

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Prevalence of pancreatic exocrine insufficiency after pancreatic surgery measured by 13C mixed triglyceride breath test: A prospective cohort study

Cited by 3 publications

References 22 publications

Involvement of the Gut Microbiome in the Local and Systemic Immune Response to Pancreatic Ductal Adenocarcinoma

Involvement of the Gut Microbiome in the Local and Systemic Immune Response to Pancreatic Ductal Adenocarcinoma

Pancreatic Exocrine Insufficiency and the Gut Microbiome in Pancreatic Cancer: A Target for Future Diagnostic Tests and Therapies?

Comprehensive, long-term evaluation of pancreatic exocrine insufficiency after pancreatoduodenectomy

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