Role of the gut microbiota in hypertriglyceridemic acute pancreatitis: potential mechanisms and therapeutic implications.

Hypertriglyceridemic acute pancreatitis (HTG-AP) is an acute, noninfectious inflammatory disease caused by excessively high levels of serum triglycerides, leading to an overproduction of free fatty acids. This damages the pancreas and disrupts pancreatic microcirculation, leading ultimately to HTG-AP. Clinically, HTG-AP is associated with increasing incidence, multiple complications, and a higher risk of severe disease or adverse outcomes. There is a lack of unified standards, both domestically and internationally, for the clinical management of HTG-AP. This presents challenges for HTG-AP treatment while also offering opportunities to explore more effective interventional approaches. Preliminary research suggests the importance of the gut microbiota in the development and progression of HTG-AP, potentially mediated by influencing lipid metabolism and inflammatory responses. However, little is known of the potential function of the gut microbiota in the etiology of HTG-AP. This review summarizes current evidence on gut microbiota alterations in HTG-AP, with emphasis on lipid metabolism, intestinal barrier injury, and immune-inflammatory pathways. We also discuss microbiota-targeted interventions as investigational strategies that require HTG-AP-specific clinical validation.