Gut microbiota and pancreatic diseases: a microbiome-associated approach in the treatment of chronic pancreatitis

Abstract

Intestinal microbiota is a factor that determines human health, maintains body homeostasis, and influences the development of pancreatic diseases (acute pancreatitis, chronic pancreatitis (CP), and cancer). Butyrate, acetate, propionate, and key short-chain fatty acids, which are synthesized by probiotic bacteria, have a significant effect on the functional pancreatic activity: anti-inflammatory effect, modulation of pancreatic β-cell function, regulation of pancreatic cell mass, and strengthening of the intestinal barrier function.
 It has been proven that the course of CP is associated with intestinal dysbiosis, bacterial overgrowth syndrome, a decrease in the levels of Firmicutes and Actinobacteria, and an increase in the levels of Proteobacteria phylum, Eubacterium rectale, Coprococcus, Sutterella, and Eubacterium ruminantium. Their predominance is related to exocrine pancreatic insufficiency, while Pseudomonas, Fusobacterium, and Ruminococcus gnavus are more common in CP patients without exocrine pancreatic insufficiency. Activation of pancreatic fibrogenesis is associated with an increase in Streptomyces, Turicibacter, Methylobacterium, Enterococcus, and Candidatus Paenicardiniummore.
 The mechanism of action of probiotics in pancreatic diseases is associated with improved functioning of the intestinal barrier, decreased BOS and the inflammatory process, and inhibition of the signaling pathway of oncogenesis. The microbiome-associated approach to treating CP is based on the additional administration of probiotics. The multicomponent probiotic Laktiale Multi can be the drug of choice.