Vonlaufen A, Spahr L, Apte MV, Frossard JL. Alcoholic pancreatitis: A tale of spirits and bacteria. World J Gastrointest Pathophysiol 2014; 5(2): 82-90 [PMID: 24891979 DOI: 10.4291/wjgp.v5.i2.82]
Corresponding Author of This Article
Jean-Louis Frossard, MD, Department of Gastroenterology, Geneva University Hospital, 4, rue Gabrielle Perret-Gentil, 1211 Geneva, Switzerland. jean-louis.frossard@hcuge.ch
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Topic Highlight
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World J Gastrointest Pathophysiol. May 15, 2014; 5(2): 82-90 Published online May 15, 2014. doi: 10.4291/wjgp.v5.i2.82
Alcoholic pancreatitis: A tale of spirits and bacteria
Alain Vonlaufen, Laurent Spahr, Minoti V Apte, Jean-Louis Frossard
Alain Vonlaufen, Gastroenterology Unit, Hôpital de la Tour, 1217 Meyrin/Genève, Switzerland
Alain Vonlaufen, Laurent Spahr, Jean-Louis Frossard, Department of Gastroenterology, University Hospital, 1211 Geneva, Switzerland
Minoti V Apte, Pancreatic Research Group, South Western Sydney Clinical School, The Ingham Institute, Liverpool, NSW 2170, Australia
Minoti V Apte, Faculty of Medicine, The University of New South Wales, Sydney, NSW 2052, Australia
Author contributions: Vonlaufen A wrote the manuscript and created the figure; Spahr L, Apte MV and Frossard JL critically appraised the manuscript and made additional suggestions.
Correspondence to: Jean-Louis Frossard, MD, Department of Gastroenterology, Geneva University Hospital, 4, rue Gabrielle Perret-Gentil, 1211 Geneva, Switzerland. jean-louis.frossard@hcuge.ch
Telephone: +41-22-3729340 Fax: +41-22-3729366
Received: October 28, 2013 Revised: April 4, 2014 Accepted: April 25, 2014 Published online: May 15, 2014
Abstract
Alcohol is a major cause of chronic pancreatitis. About 5% of alcoholics will ever suffer from pancreatitis, suggesting that additional co-factors are required to trigger an overt disease. Experimental work has implicated lipopolysaccharide, from gut-derived bacteria, as a potential co-factor of alcoholic pancreatitis. This review discusses the effects of alcohol on the gut flora, the gut barrier, the liver-and the pancreas and proposes potential interventional strategies. A better understanding of the interaction between the gut, the liver and the pancreas may provide valuable insight into the pathophysiology of alcoholic pancreatitis.
Core tip: There is now clear clinical and experimental evidence that bacteria and bacterial products (such as endotoxin) are associated with complications of pancreatitis. Furthermore, results of animal studies support the concept that bacterial endotoxin is an important factor in the initiation and progression of alcoholic pancreatitis.
