Dysbiosis of Intestinal Microbiota Associated With Inflammation Involved in the Progression of Acute Pancreatitis.
OBJECTIVE
To evaluate alterations of the intestinal bacteria and its associations with the inflammation in acute pancreatitis (AP).


METHODS
A multihospital prospective clinical study was conducted, and a total of 108 participants were enrolled in our study, including 44 with severe AP (SAP), 32 with mild AP (MAP), and 32 healthy volunteers. The structure of intestinal microbiota, 10 predominant bacteria, plasma endotoxin, and serum cytokines were investigated by polymerase chain reaction-denaturing gradient gel electrophoresis, real-time quantitative polymerase chain reaction, Limulus amebocyte lysate tests, and enzyme-linked immunosorbent assays, respectively.


RESULTS
Dramatic alterations in the predominant fecal microbiota were observed in most of both MAP and SAP patients. In addition, the rates of the multiorgan failures and infectious complications in the patients with SAP with altered intestinal microbiota were significantly higher than in those whose intestinal microbiota remained unaltered. Enterococcus increased and Bifidobacterium decreased in the patients with SAP compared to the patients with MAP. Serum IL-6 were positively correlated with Enterobacteriaceae and Enterococcus and negatively correlated with Bifidobacterium, whereas plasma endotoxin positively correlated with Enterococcus (P < 0.05).


CONCLUSIONS
The intestinal bacteria most frequently altered in both the patients with MAP and those with SAP significantly correlated with inflammation, which indicated that the intestinal microbiota may be involved in the progression of AP.
From the *Department of Clinical Laboratory, Hunan Provincial People's Hospital; †Department of Clinical Biochemistry, Xiangya School of Medicine, Central South University, Changsha, Hunan; ‡Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang; §Department of Emergency, Hunan Provincial People's Hospital; ∥Department of Neurosurgery, the Third Xiangya Hospital, Central South University; and ¶Department of Gastroenterology, Hunan Provincial People's Hospital, Changsha, Hunan, China.
Chaochao
C
Tan
Zongxin
Z
Ling
Ying
Y
Huang
Youde
Y
Cao
Qiang
Q
Liu
Tao
T
Cai
Hao
H
Yuan
Changjun
C
Liu
Yunfeng
Y
Li
Keqian
K
Xu
D000208:Acute Disease; D000328:Adult; D001419:Bacteria / Q000145:classification* / Q000235:genetics / Q000276:immunology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002681:China; D016207:Cytokines / Q000097:blood; D004269:DNA, Bacterial / Q000235:genetics; D058645:Denaturing Gradient Gel Electrophoresis; D018450:Disease Progression; D064806:Dysbiosis; D004731:Endotoxins / Q000097:blood; D005243:Feces / Q000382:microbiology; D005260:Female; D054884:Host-Pathogen Interactions; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007422:Intestines / Q000382:microbiology*; D008297:Male; D064307:Microbiota; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000382:microbiology; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D012720:Severity of Illness Index
D015415:Biomarkers; D016207:Cytokines; D004269:DNA, Bacterial; D004731:Endotoxins; D018836:Inflammation Mediators