Abstract
In severe acute pancreatitis, endotoxemia and/or the infection of the pancreas and/or prepancreatic necrosis are thought to derive from the translocation of bacteria from the gut. Bacterial translocation has been reported to occur in conditions with reduced gut integrity, an impairment of systemic and gut immunity, or bacterial overgrowth. In acute pancreatitis, bacterial overgrowth resueting from paralytic ileus has been reported. In addition, we have noted an impairment of systemic and gut immunity as a result of lymphocyte apoptosis and an increase in gut permeability from apoptosis of the intestinal epithelial cells in experimental pancreatitis. In fact, the inhibition of caspases, which are key enzymes for the induction of apoptosis, ameliorated endotoxemia via the maintenance of systemic and gut immunity and gut integrity.
