Dysbiosis in benign and malignant diseases of the exocrine pancreas

The consequences of dysbiosis in pancreatic diseases remain unclear, with a limited body of evidence suggesting that there may be an association between dysbiosis and pancreatic disease; however, some of the studies show contradictory results. Regarding acute and chronic pancreatitis, data are scarce, but dysbiosis appears to be present in both conditions. Some studies show lower levels of Bifidobacterium or Lactobacillus and higher levels of Enterobacteriaceae in chronic pancreatitis. One study shows higher levels of Enterococcus and lower levels of Bifidobacterium in acute pancreatitis. There is stronger evidence of a link between microbiota imbalance and pancreatic cancer. There is an overall association between pancreatic cancer and lower levels of Neisseria elongate and Streptococcus mitis and higher levels of Porphyromonas gingivalis and Granulicatella adiacens. However, further investigation is required to confirm these findings, and to explore clinical implications such as screening and therapeutic possibilities.