Intestinal Mucosal Immune Barrier: A Powerful Firewall Against Severe Acute Pancreatitis-Associated Acute Lung Injury via the Gut-Lung Axis

• DOI: 10.2147/jir.s448819
• Publication Date: 2024-04-10T05:55:06Z
• Authors: Fan Li; Zhengjian Wang; Yinan Cao; Boliang Pei; Xinyu Luo; Jin Liu; Peng Ge; Yalan Luo; Shurong Ma; Hailong Chen
• Keywords: intestinal mucosal immune barrier; 0303 health sciences; 03 medical and health sciences; gut microbiota; severe acute pancreatitis-associated acute lung injury; gut-lung axis; Pathology; RB1-214; Therapeutics. Pharmacology; RM1-950; Review; migration of immune cells.

The pathogenesis of severe acute pancreatitis-associated acute lung injury (SAP-ALI), which is the leading cause of mortality among hospitalized patients in the intensive care unit, remains incompletely elucidated. The intestinal mucosal immune barrier is a crucial component of the intestinal epithelial barrier, and its aberrant activation contributes to the induction of sustained pro-inflammatory immune responses, paradoxical intercellular communication, and bacterial translocation. In this review, we firstly provide a comprehensive overview of the composition of the intestinal mucosal immune barrier and its pivotal roles in the pathogenesis of SAP-ALI. Secondly, the mechanisms of its crosstalk with gut microbiota, which is called gut-lung axis, and its effect on SAP-ALI were summarized. Finally, a number of drugs that could enhance the intestinal mucosal immune barrier and exhibit potential anti-SAP-ALI activities were presented, including probiotics, glutamine, enteral nutrition, and traditional Chinese medicine (TCM). The aim is to offer a theoretical framework based on the perspective of the intestinal mucosal immune barrier to protect against SAP-ALI.