Xiao-Fan Song, Yi Liu, Qiaoman Fei, Chunlan Xu, Fan-Pu Ji
Acute pancreatitis (AP) is sudden inflammation of the pancreas, which can lead to multiple organ dysfunction in severe cases. Hypertriglyceridemia (HTG) is the third most common cause. In recent years, HTG-induced AP (HTG-AP) has garnered increasing attention. Compared to AP caused by other causes, HTG-AP often has a more subtle onset but is more likely to progress to a severe, critical illness that poses a serious threat to a patient's life and health. Research suggests a potential connection between the gut microbiota and AP, which could be mediated by bacterial metabolites, immune cells, and inflammatory factors. This is supported by observations of microbial imbalance and higher intestinal permeability in patients with AP. In addition, studies have shown that HTG-induced changes in gut microbiota can worsen AP by negatively impacting the host metabolism, immune response, and function of the intestinal barrier. In this review, we summarize recent clinical and animal studies on the role and mechanism of gut microbiota in the severity of AP aggravated by HTG. The application prospects of the newly proposed microbial-host-isozyme concept are summarized, focusing on its potential for the precision diagnosis and treatment of HTG-AP through gut microbiota regulation.