{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T05:47:40Z","timestamp":1794203260935,"version":"4.8.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Severe acute pancreatitis (SAP) is frequently accompanied by intestinal barrier disruption, systemic inflammation, and gut microbiota dysbiosis. Although enteral nutrition (EN) is standard in SAP management, EN alone may not fully restore the intestinal microenvironment. This study evaluated whether probiotics combined with EN improve intestinal mucosal integrity, inflammatory responses, immune status, nutritional indices, and intestinal flora in SAP patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this prospective, randomized, double-blind, placebo-controlled trial, 130 SAP patients were assigned to receive EN plus probiotics or EN plus placebo for 14 days. All patients received standardized supportive care and post-pyloric EN. Outcomes included time to abdominal pain relief, hospital stay, mortality, persistent organ failure, ICU utilization, intestinal mucosal barrier markers (endotoxin, diamine oxidase), inflammatory cytokines (CRP, TNF-\u03b1, IL-6), immune indicators (IgG, IgM, IgA), nutritional markers (prealbumin, albumin, transferrin), and quantitative fecal microbiota counts at baseline, day 7, and day 14. Statistical significance was defined as\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with controls, the probiotic group showed shorter abdominal pain relief time (4.21 \u00b1 0.53 vs. 5.85 \u00b1 0.62 days) and reduced hospital stay (20.02 \u00b1 2.14 vs. 26.34 \u00b1 3.25 days) (both\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05). No differences were found in 28-day mortality, in-hospital mortality, persistent organ failure, ICU admission, or ICU stay. Probiotics produced greater reductions in endotoxin, diamine oxidase, CRP, TNF-\u03b1, and IL-6, and greater increases in IgG, IgM, IgA, prealbumin, albumin, and transferrin. The study group also exhibited higher lactobacilli and bifidobacteria counts and lower enterobacteria and enterococci counts at days 7 and 14 (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Probiotics combined with EN improved intestinal barrier function, inflammation, immunity, nutrition, and microbiota composition, although without reducing mortality or major complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1766361","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:29:23Z","timestamp":1773034163000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Influences of probiotics plus enteral nutrition on intestinal flora and inflammatory response in patients with severe acute pancreatitis"],"prefix":"10.3389","volume":"13","author":[{"given":"Liping","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Changzhou Cancer Hospital","place":["Changzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunying","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Changzhou Cancer Hospital","place":["Changzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Changzhou Cancer Hospital","place":["Changzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhong","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Changzhou Cancer Hospital","place":["Changzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1001\/jama.2020.20317","article-title":"Acute pancreatitis: a review","volume":"325","author":"Mederos","year":"2021","journal-title":"JAMA"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"795","DOI":"10.5152\/tjg.2023.23175","article-title":"Acute pancreatitis review","volume":"34","author":"Huang","year":"2023","journal-title":"Turk J Gastroenterol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"2024","DOI":"10.1136\/gutjnl-2016-313595","article-title":"Acute pancreatitis: recent advances through randomised trials","volume":"66","author":"van Dijk","year":"2017","journal-title":"Gut"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/s1499-3872(16)60163-7","article-title":"Severe acute pancreatitis: pathogenesis, diagnosis 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pancreatitis-current standards","volume":"13","author":"Jab\u0142o\u0144ska","year":"2021","journal-title":"Nutrients"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"96","DOI":"10.29271\/jcpsp.2020.01.96","article-title":"Efficacy of microecopharmaceutics combined with early enteral nutrition support in the treatment of severe acute pancreatitis","volume":"30","author":"Qiu","year":"2020","journal-title":"J Coll Physicians Surg Pak"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.9734\/ajbgmb\/2024\/v16i8397","article-title":"Emerging role of probiotics in advancement of combating physical abnormalities and diseases: a systematic perspective analysis","volume":"16","author":"Eva","year":"2024","journal-title":"Asian J Biochem Genet Mol Biol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"356","DOI":"10.3390\/nu15020356","article-title":"Postoperative probiotics administration attenuates gastrointestinal complications and gut microbiota dysbiosis caused by chemotherapy in colorectal cancer patients","volume":"15","author":"Huang","year":"2023","journal-title":"Nutrients"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"R57","DOI":"10.1186\/cc13809","article-title":"Use of probiotics in the treatment of severe acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials","volume":"18","author":"Gou","year":"2014","journal-title":"Crit Care"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"224","DOI":"10.3760\/cma.j.issn.2095-4352.2013.04.011","article-title":"The effects of early enteral nutrition with addition of probiotics on the prognosis of patients suffering from severe acute pancreatitis","volume":"25","author":"Cui","year":"2013","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e36454","DOI":"10.1097\/md.0000000000036454","article-title":"Effectiveness and safety of probiotics on patients with severe acute pancreatitis: a systematic review and meta-analysis","volume":"102","author":"Gao","year":"2023","journal-title":"Medicine"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"3441","DOI":"10.3390\/nu14163441","article-title":"Early enteral nutrition in paediatric acute pancreatitis\u2014a review of published studies","volume":"14","author":"Bukowski","year":"2022","journal-title":"Nutrients"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"2127456","DOI":"10.1080\/19490976.2022.2127456","article-title":"Bifidobacterium spp. and their metabolite lactate protect against acute pancreatitis via inhibition of pancreatic and systemic inflammatory responses","volume":"14","author":"Li","year":"2022","journal-title":"Gut Microbes"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"281","DOI":"10.5114\/pg.2022.118164","article-title":"Evaluation of the effect of probiotics on septic complications in patients with severe acute pancreatitis. A systematic review and meta-analysis","volume":"18","author":"Malik","year":"2023","journal-title":"Prz Gastroenterol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1038\/nbt.3436","article-title":"A reassessment of the PROPATRIA study and its implications for probiotic therapy","volume":"34","author":"Bongaerts","year":"2016","journal-title":"Nat Biotechnol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1186\/s12906-023-03998-7","article-title":"Effects of probiotics on pancreatic inflammation and intestinal integrity in mice with acute pancreatitis","volume":"23","author":"Werawatganon","year":"2023","journal-title":"BMC Complement Med Ther"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1766361\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:29:25Z","timestamp":1773034165000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1766361\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":19,"alternative-id":["10.3389\/fmed.2026.1766361"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1766361","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]},"article-number":"1766361"}}