急性胰腺炎肠–免疫轴失衡及调控机制进展

Dysregulation of the Gut-Immune Axis in Acute Pancreatitis and Advances in Its Regulatory Mechanisms

摘要: 急性胰腺炎(AP)是一种常见的急腹症，其严重程度与全身炎症反应综合征和多器官功能障碍密切相关。近年来，肠–免疫轴在AP发病机制中的核心作用日益凸显，成为研究热点。本文综述了AP状态下肠屏障功能障碍、肠道菌群失调及免疫细胞异常活化之间复杂的相互作用网络，重点探讨了肠–免疫轴失衡的关键分子机制，包括肠道通透性增加、细菌移位、免疫细胞极化失衡及细胞因子风暴等核心环节。同时，本文系统总结了基于调控肠–免疫轴的潜在治疗策略，如益生菌、肠道屏障保护剂及免疫调节剂等的研究进展，旨在为AP的临床治疗提供新的理论依据和干预靶点。

Abstract: Acute pancreatitis (AP) is a common acute abdominal condition whose severity is closely associated with systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction (MODS). In recent years, the central role of the gut-immune axis in the pathogenesis of AP has become increasingly evident and has emerged as a research hotspot. This review summarizes the complex interaction network among intestinal barrier dysfunction, gut microbiota dysbiosis, and aberrant immune cell activation in the setting of AP. It focuses on the key molecular mechanisms underlying gut-immune axis imbalance, including increased intestinal permeability, bacterial translocation, dysregulated immune cell polarization, and cytokine storms. Furthermore, this review systematically outlines the research progress of potential therapeutic strategies aimed at modulating the gut-immune axis, such as probiotics, intestinal barrier protectants, and immunomodulators. The goal is to provide new theoretical insights and identify potential intervention targets for the clinical management of AP.