Exploring Microbial Mediation Effect in Acute Pancreatitis: A Path to Understanding Disease Mechanism.

Acute pancreatitis (AP) is an inflammatory disease of the pancreas with mortality rates up to 20% in the setting of severe disease. The most common etiologies for AP are gallstones, heavy alcohol use, injury in the abdomen, side effects of some medications, or hypertriglyceridemia [59]. Even though our understanding of pancreatic diseases has broadened, little information on the role of diet and gut microbiome on the initiation and progression of AP is available. Diet and gut microbiome dysbiosis are closely related to human health and disease, with recent studies suggesting that gut microbiome is associated with AP. To ascertain the causal effect that the microbiome may have on AP as a method outcome, this study explores the mediation effect of gut microbiome dysbiosis and, eventually, the potential relationship between diet intake, gut microbiome, and the course of pancreatic diseases. The objective includes (1) finding foods and dietary features and bacteria directly associated with the AP outcome and (2) conducting univariate and multivariate mediation analysis to identify exposure-mediator combinations that affect AP outcome. This research aims to reveal the disease's causation through mediation analysis. The results may help us identify diet- and gut microbiome- targets in AP that can be utilized to develop preventive and therapeutic strategies to decrease the burden of AP.