Open AccessChronic pancreatitis and the intestinal microbiome in adults and children: Not only SIBO but also gut dysbiosis has clinical significance
Author(s) -
Stanislav Sitkin,
Tatiana Pervunina
Publication year - 2022
Publication title -
èksperimentalʹnaâ i kliničeskaâ gastroènterologiâ
Language(s) - English
Resource type - Journals
ISSN - 1682-8658
DOI - 10.31146/1682-8658-ecg-196-12-125-133
Subject(s) - dysbiosis , firmicutes , pancreatitis , eubacterium , faecalibacterium prausnitzii , gut flora , medicine , butyrate , bacteroides , microbiome , small intestinal bacterial overgrowth , microbiology and biotechnology , prevotella , bifidobacterium , gastroenterology , biology , immunology , bacteria , bioinformatics , irritable bowel syndrome , lactobacillus , biochemistry , 16s ribosomal rna , fermentation , genetics
Chronic pancreatitis is accompanied by both small intestinal bacterial overgrowth and dysbiosis of the gut microbiota. The most typical changes in the gut microbiota in chronic pancreatitis are a decrease in microbial diversity, an increase in the abundance of Proteobacteria, a decrease in the abundance of Bacteroidetes, Actinobacteria, and Firmicutes, especially butyrate-producing bacteria such as Faecalibacterium , a significant association with infectious pathways (KEGG analysis]), concomitant metabolic disorders (diabetes mellitus) and exocrine pancreatic insufficiency. Changes in the gut microbiota in children with chronic pancreatitis are like those in adults and are characterized by a decrease in α-diversity and the loss of shortchain fatty acid producers: butyrate-producing Faecalibacterium , Subdoligranulum , and Eubacterium , propionate-producing Phascolarctobacterium , acetate- and lactate-producing Collinsella , and probiotic Bifidobacterium . Dysbiotic changes in the gut microbiome, including a decrease in the abundance of commensal symbionts, are significantly associated with the severity of chronic pancreatitis. The most important factor influencing the intestinal microbiota is the pancreatic exocrine function, a decrease which leads to a switch from enterotype 1 ( Bacteroides predominance) to enterotype 2 ( Prevotella predominance) and a decrease in phylogenetic diversity (α-diversity index). Modulation of the dysbiotic gut microbiota can be carried out with probiotics, prebiotics, bacterial metabolites such as butyrate, pancreatic enzymes and should become a full-fledged therapeutic option in patients with chronic pancreatitis.