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Background  Infectious complications often occur in acute pancreatitis, related to impaired intestinal barrier function, with prolonged disease course and even mortality as a result. The bile salt nuclear receptor farnesoid X receptor (FXR), which is expressed in the ileum, liver and other organs including the pancreas, exhibits anti-inflammatory effects by inhibiting NF-κB activation and is implicated in maintaining intestinal barrier integrity and preventing bacterial overgrowth and translocation. Here we explore, with the aid of complementary animal and human experiments, the potential role of FXR in acute pancreatitis.    Methods  Experimental acute pancreatitis was induced using the CCK-analogue cerulein in wild-type and  Fxr -/-   mice. Severity of acute pancreatitis was assessed using histology and a semi-quantitative scoring system. Ileal permeability was analyzed  in vitro  by Ussing chambers and an  in vivo  permeability assay. Gene expression of  Fxr  and  Fxr  target genes was studied by quantitative RT-PCR. Serum FGF19 levels were determined by ELISA in acute pancreatitis patients and healthy volunteers. A genetic association study in 387 acute pancreatitis patients and 853 controls was performed using 9 tagging single nucleotide polymorphisms (SNPs) covering the complete  FXR  gene and two additional functional SNPs.    Results  In wild-type mice with acute pancreatitis, ileal transepithelial resistance was reduced and ileal mRNA expression of  Fxr  target genes  Fgf15 ,  SHP , and  IBABP  was decreased. Nevertheless,  Fxr -/-   mice did not exhibit a more severe acute pancreatitis than wild-type mice. In patients with acute pancreatitis, FGF19 levels were lower than in controls. However, there were no associations of  FXR  SNPs or haplotypes with susceptibility to acute pancreatitis, or its course, outcome or etiology.    Conclusion  We found no evidence for a major role of FXR in acute human or murine pancreatitis. The observed altered Fxr activity during the course of disease may be a secondary phenomenon.

Impact of Global Fxr Deficiency on Experimental Acute Pancreatitis and Genetic Variation in the FXR Locus in Human Acute Pancreatitis