Intestinal barrier damage, systemic inflammatory response syndrome, and acute lung injury: A troublesome trio for acute pancreatitis

• Main Authors: Peng Ge, Yalan Luo, Chukwuemeka Samuel Okoye, Haiyang Chen, Jiayue Liu, Guixin Zhang, Caiming Xu, Hailong Chen
• Format: Article
• Language: English
• Published: Elsevier 2020-12-01
• Series: Biomedicine & Pharmacotherapy
• Subjects: Severe acute pancreatitis; Lung injury; Systemic inflammatory response syndrome; Intestinal barrier; Pathogen-associated molecular patterns; Damage-associated molecular patterns
• Online Access: http://www.sciencedirect.com/science/article/pii/S075333222030963X

Severe acute pancreatitis (SAP), a serious inflammatory disease of the pancreas, can easily lead to systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndromes (MODS). Acute lung injury (ALI) is one of the most serious complications of SAP. However, the specific pathogenesis of SAP-associated ALI is not fully understood. Crosstalk and multi-mechanisms involving pancreatic necrosis, bacteremia, intestinal barrier failure, activation of inflammatory cascades and diffuse alveolar damage is the main reason for the unclear pathological mechanism of SAP-associated ALI. According to previous research on SAP-associated ALI in our laboratory and theories put forward by other scholars, we propose that the complex pattern of SAP-associated ALI is based on the “pancreas-intestine-inflammation/endotoxin-lung (P-I-I/E–L) pathway”. In this review, we mainly concentrated on the specific details of the “P-I-I/E–L pathway” and the potential treatments or preventive measures for SAP-associated ALI.