Early gut mucosal dysfunction in patients with acute pancreatitis

Area of Science:

• Gastroenterology
• Critical Care Medicine
• Pathophysiology

Background:

• Acute pancreatitis (AP) is a serious condition with significant morbidity and mortality.
• Gut mucosal integrity plays a crucial role in the systemic response to AP.
• Understanding gut barrier dysfunction is key to managing AP complications.

Purpose of the Study:

• To investigate gut mucosal damage in acute pancreatitis (AP) patients.
• To correlate mucosal damage with endotoxemia, systemic inflammation, disease severity, septic complications, and patient outcomes.

Main Methods:

• A clinical study involving AP patients categorized by severity (mild, severe AP without organ dysfunction, severe AP with organ dysfunction) and healthy controls.
• Assessed intestinal permeability using lactulose/mannitol and d-xylose absorption ratios.
• Measured endotoxin and tumor necrosis factor alpha levels.

Main Results:

• Increased lactulose/mannitol absorption ratio and decreased d-xylose absorption in AP patients, more pronounced in severe cases.
• Significant positive correlation between mucosal permeability, endotoxin, and tumor necrosis factor alpha.
• Gut mucosal damage severity correlated with AP severity and septic complications.

Conclusions:

• Intestinal mucosal function is impaired early in AP, particularly in patients with organ dysfunction.
• This early gut barrier injury may drive multiple organ dysfunction and predict adverse outcomes in AP.