Lactulose regulates gut microbiota dysbiosis and promotes short-chain fatty acids production in acute pancreatitis patients with intestinal dysfunction
Open accessAbstract
Intestinal dysfunction is one of the common complications in the early stage of acute pancreatitis (AP), which often associates with bad outcome. Lactulose, as a prebiotic, has been widely used to improve gut health, yet its effect on AP is unclear. This was a prospective, randomized trial of moderate severe AP patients complicated with intestinal dysfunction. A total of 73 participants were randomly assigned to receive either lactulose or Chinese herb rhubarb for 1 week. The primary efficacy endpoint was the recovery of intestinal function. The serum levels of inflammatory cytokines and gut barrier indexes were examined. The fecal samples from patients before and after treatment were collected. 16 S rRNA gene sequencing analysis was performed to explore the composition of gut microbiota and the amount of short-chain fatty acids (SCFAs) were detected by gas chromatography-mass spectrometry (GC-MS). The intestinal dysfunction was prominently improved after 7 days of treatment with either lactulose or rhubarb. The serum levels of cytokines and gut permeability index were decreased after treatment, with stronger down-regulated degree in lactulose group than rhubarb. The potential beneficial genus Bifidobacterium was enriched in lactulose group, while pathogenic bacteria including Escherichia-Shigella and Neisseria were abundant in rhubarb group. Of note, the level of SCFAs was remarkably increased after treatment, with higher amount in lactulose group than rhubarb group. Lactulose could not only restore intestinal function but also regulate gut microbiota and promote the production of SCFAs.
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Intestinal barrier dysfunction is an early severe complication in AP, leading to multi-organ infections and worsening disease progression.
“Intestinal barrier dysfunction is widely acknowledged as an early severe complication in AP, leading to multi-organ infections and worsening disease progression (Agarwal et al. 2023; Wang et al. 2023).”
From Odoribacter laneus protects intestinal barrier by bile acid-FXR axis in acute pancreatitis (2026) · cites this paper as Wang et al. 2023
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Odoribacter laneus protects intestinal barrier by bile acid-FXR axis in acute pancreatitis
Gu, R., Li, J., Qi, J., Sun, R., Wu, H., & Jin, B. (2026) · AMB Express · doi:10.1186/s13568-026-02071-z · Cited by 2 · see citing works
“Intestinal barrier dysfunction, characterized by the loss of tight junction protein and increased inflammatory activity, is a common complication of AP (Agarwal et al. 2023; Wang et al. 2023).”
- Authors
- Wang, J., Jiang, M., Hu, Y., Lei, Y., Zhu, Y., Xiong, H., & He, C.
- Affiliations
- First Affiliated Hospital of Nanchang University (CN)
- Corresponding author
- Xiong, Huifang
- He, Cong
- Venue
- Biomedicine & Pharmacotherapy
- Publisher
- Elsevier BV
- Published
- 2023-07
- Volume
- 163
- Issue
- 1
- Pages
- 114769
- ISSN
- 0753-3322 (ISSN-L)
- OpenAlex
- W4367047375
- Cited by
- 33
- References
- 30
- Citations by year
- 2026: 13 · 2025: 8 · 2024: 7 · 2023: 5
- FWCI
- 2.93
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Biomedicine & Pharmacotherapy (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Natural Science Foundation of China (82260133)
- Key Research and Development Program of Jiangxi Province (20202BABL216007, 20204BCJL23048)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- lactulose, acute pancreatitis, intestinal dysfunction, gut dysbiosis, short-chain fatty acids, prebiotics, rhubarb, Bifidobacterium, intestinal permeability, inflammatory cytokines, Escherichia-Shigella, Neisseria
- MeSH terms
- Gastrointestinal Microbiome, Acute Disease, Fatty Acids, Volatile, Humans, Intestinal Diseases, Lactulose, Pancreatitis, Prospective Studies, Cytokines, Dysbiosis
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