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Letter
Short-chain fatty acids in patients with severe acute pancreatitis: friend or foe?
  1. Fons F van den Berg1,
  2. Marc G Besselink2,
  3. Hjalmar van Santvoort3
  1. 1 Department of Medical Microbiology and Infection Prevention, Amsterdam UMC Locatie AMC, Amsterdam, Noord-Holland, Netherlands
  2. 2 Department of Surgery, Amsterdam UMC Locatie VUmc, Amsterdam, Noord-Holland, Netherlands
  3. 3 Department of Surgery, UMC Utrecht, Utrecht, Utrecht, Netherlands
  1. Correspondence to Dr Fons F van den Berg, Department of Medical Microbiology and Infection Prevention, Amsterdam UMC Location AMC, Amsterdam, Noord-Holland, Netherlands; f.f.vandenberg{at}amsterdamumc.nl

https://doi.org/10.1136/gutjnl-2024-332129

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    With great interest, we read the paper by Ammer-Hermenau et al, which features a multicentre microbiome study that included buccal and rectal samples taken at admission from 450 patients with acute pancreatitis.1 Severe acute pancreatitis was post hoc defined as persistent organ failure and/or collections that required drainage. These patients were propensity score matched with patients with mild acute pancreatitis. Remarkedly, over-representation of 10 known short-chain fatty acid (SCFA)-producing bacteria was found in the severe group. The authors conclude that SCFAs might be associated with worse outcomes and speculate that the increased mortality that was observed in the intervention group of the Probiotics in Pancreatitis Trial (PROPATRIA) could be explained by SCFA producers in the probiotics formula.2 There are, however, some limitations to this study, and we believe the author’s statements are in need of nuance.

    First, the authors did not include a control group of healthy volunteers. Therefore, it is not possible to conclude from these data that SCFA producers are increased in the severe acute pancreatitis group or decreased in the mild group, compared with healthy subjects.

    Second, the authors …

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    Footnotes

    • X @marcbesselink

    • Contributors Not applicable.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.