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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

A Journal on Gastroenterology, Nutrition and Dietetics


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Minerva Gastroenterologica e Dietologica 2017 Feb 24

DOI: 10.23736/S1121-421X.17.02387-X

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Gut microbiota and pancreatic diseases

Marianna SIGNORETTI, Roberta ROGGIOLANI, Caterina STORNELLO, Gianfranco DELLE FAVE, Gabriele CAPURSO

Digestive and Liver Disease Unit, S. Andrea Hospital, University Sapienza, Rome, Italy


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Changes in diet, lifestyle and exposition to environmental risk factors account for the increased incidence of pancreatic disorders, including acute and chronic pancreatitis, and pancreatic cancer. The role of the microbiome in the development of pancreatic disorders is increasingly recognized. The translocation of gut bacteria and endotoxins following gut barrier failure is a key event contributing to the severity of acute pancreatitis, while small intestine bacterial overgrowth is common in patients with chronic pancreatitis and further worsens their symptoms and malnutrition. Specific molecular mimicry link the microbiome and Helicobacter pylori with autoimmune pancreatitis. Changes in the oral microbiome typical of periodontitis seem associated with an increased risk of developing pancreatic cancer. The composition of the gut microbiota is also unbalanced in the presence of risk factors for pancreatic cancer, such as obesity, smoking and diabetes. Helicobacter pylori infection, atrophic body gastritis and related decreased gastric acid secretion also seem associated with the risk of pancreatic cancer, although this area needs further research. The link between dysbiosis, immune response and proinflammatory status is most likely the key for these associations. The present review article will discuss current available evidence on the role of gut microbiota in pancreatic disorders, highlighting potential areas for future research.


KEY WORDS: Microbiota - Helicobacter pylori - Periodontitis - Pancreatitis - Pancreatic cancer

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gabriele.capurso@gmail.com