# Microbiome of the Proximal Small Intestine in Patients with Acute Pancreatitis

## TL;DR

This study explores the small intestine microbiome in patients with acute pancreatitis and finds that its composition is linked to disease severity and outcomes.

## Contribution

The study provides novel insights into the small intestinal microbiome in acute pancreatitis and identifies specific microbial associations with disease severity.

## Key findings

- The small intestinal microbiome in acute pancreatitis is dominated by Streptococcus, Veillonella, and other genera.
- Severe disease correlates with reduced abundance of Neisseria mucosa, Parvimonas micra, and Megasphaera micronuciformis.
- Higher abundance of Streptococcus and Enterobacteriaceae is observed in more severe cases.

## Abstract

Currently, due to the complexity of obtaining samples, specific features of laboratory processing and analysis of the results, there is a lack of data on the microbial signature of the small intestine in healthy and diseased states of the upper gastrointestinal tract. Objective: To investigate the characteristics of the small intestinal microbiome in acute pancreatitis of varying severity and to identify correlations with clinical factors. Methods: This study included 30 patients with acute pancreatitis of varying severity treated between 1 January 2019 and 31 December 2021. The composition of the microbiota was analyzed by metagenomic sequencing of the 16S rRNA gene from jejunal samples. Results: The mortality rate in the study group was 23.3%. The small intestinal microbiome was dominated by Streptococcus (median relative abundance 19.2%, interquartile range 6.4–35.1%), Veillonella (3.4%; 0.6–7%), Granulicatella (2.7%; 0.6–5%), Fusobacterium (2.2%; 0.3–5.9%), Prevotella (1.5%; 0.3–8%), Haemophilus (0.9%; 0.2–10%), Gemella (0.8%; 0.2–4.3%), and Lactobacillus (0.2%; 0.1–0.9%). More severe disease was associated with decreased abundance of Neisseria mucosa, Parvimonas micra, and Megasphaera micronuciformis. In contrast, the relative abundance of the genera Streptococcus (species S. rubneri/parasanguinis/australis), Actinomyces, and several genera within the family Enterobacteriaceae was higher in these patients. Conclusions: The state of the microbiota has important prognostic value and correlates with the duration from the onset of the pain syndrome to the time of receiving qualified care in the hospital.