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Microbiota in pancreatic health and disease: the next frontier in microbiome research

Abstract

Diseases intrinsic to the pancreas such as pancreatitis, pancreatic cancer and type 1 diabetes mellitus impart substantial health and financial burdens on society but identification of novel mechanisms contributing to these pathologies are slow to emerge. A novel area of research suggests that pancreatic-specific disorders might be modulated by the gut microbiota, either through a local (direct pancreatic influence) or in a remote (nonpancreatic) fashion. In this Perspectives, we examine literature implicating microorganisms in diseases of the pancreas, specifically pancreatitis, type 1 diabetes mellitus and pancreatic ductal adenocarcinoma. We also discuss evidence of an inherent pancreatic microbiota and the influence of the intestinal microbiota as it relates to disease association and development. In doing so, we address pitfalls in the current literature and areas of investigation that are needed to advance a developing field of research that has clinical potential to reduce the societal burden of pancreatic diseases.

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Fig. 1: Proposed models of bacterial translocation to the pancreas and the homeostatic host response.
Fig. 2: Interactions between intestinal microbiota and the development of type 1 diabetes mellitus.
Fig. 3: Proposed relationship between bacteria and development of pancreatic cancer.
Fig. 4: Areas of clinical interest to modulate microbiota influence on pancreatic disease.

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Acknowledgements

C.J. is funded by NIH grants R01DK073338 and R01AT008623, and the University of Florida Department of Medicine Gatorade Fund. R.M.T. is supported by the American Cancer Society Norma and Rich DiMarco Mentored Research Scholar Grant (MRSG-17-228-01-TBG) and University of Florida Health Cancer Center Pilot Project Grant.

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Nature Reviews Gastroenterology & Hepatology thanks J. Diana, D. Saxena and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

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Correspondence to Christian Jobin.

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Thomas, R.M., Jobin, C. Microbiota in pancreatic health and disease: the next frontier in microbiome research. Nat Rev Gastroenterol Hepatol 17, 53–64 (2020). https://doi.org/10.1038/s41575-019-0242-7

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