与胰腺疾病相关的肠道和全身性疾病的临床与病理生理学概述：因果关系还是附带损害？
A Clinical and Pathophysiological Overview of Intestinal and Systemic Diseases Associated with Pancreatic Disorders: Causality or Casualty?
作者信息
Conti Bellocchi Maria Cristina, Crinò Stefano Francesco, De Marchi Giulia, De Pretis Nicolò, Ofosu Andrew, Caldart Federico, Ciccocioppo Rachele, Frulloni Luca
机构信息
Diagnostic and Interventional Endoscopy of Pancreas, Pancreas Institute, University of Verona, 37134 Verona, Italy.
Gastroenterology Unit, Department of Medicine, Pancreas Institute, University of Verona, 37134 Verona, Italy.
出版信息
Biomedicines. 2023 May 8;11(5):1393. doi: 10.3390/biomedicines11051393.
The relationship between chronic intestinal disease, including inflammatory bowel disease (IBD) and celiac disease (CelD), and pancreatic disorders has been little investigated. Although an increased risk of acute pancreatitis (AP), exocrine pancreatic insufficiency with or without chronic pancreatitis, and chronic asymptomatic pancreatic hyperenzymemia have been described in these patients, the pathogenetic link remains unclear. It may potentially involve drugs, altered microcirculation, gut permeability/motility with disruption of enteric-mediated hormone secretion, bacterial translocation, and activation of the gut-associated lymphoid tissue related to chronic inflammation. In addition, the risk of pancreatic cancer seems to be increased in both IBD and CelD patients with unknown pathogenesis. Finally, other systemic conditions (e.g., IgG4-related disease, sarcoidosis, vasculitides) might affect pancreatic gland and the intestinal tract with various clinical manifestations. This review includes the current understandings of this enigmatic association, reporting a clinical and pathophysiological overview about this topic.
包括炎症性肠病（IBD）和乳糜泻（CelD）在内的慢性肠道疾病与胰腺疾病之间的关系鲜有研究。尽管已有报道称这些患者患急性胰腺炎（AP）、伴或不伴慢性胰腺炎的外分泌性胰腺功能不全以及慢性无症状性胰腺高酶血症的风险增加，但其发病机制仍不清楚。这可能涉及药物、微循环改变、肠道通透性/蠕动以及肠介导的激素分泌紊乱、细菌移位以及与慢性炎症相关的肠道相关淋巴组织激活。此外，IBD和CelD患者患胰腺癌的风险似乎也会增加，但其发病机制不明。最后，其他全身性疾病（如IgG4相关疾病、结节病、血管炎）可能会以各种临床表现影响胰腺和肠道。本综述涵盖了对这一神秘关联的当前认识，报告了关于该主题的临床和病理生理学概述。
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