Pancreatitis – Microbiome As Predictor of Severity (P-MAPS): A prospective international multicentre translational study

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Introduction Early prediction of the course and severity of acute pancreatitis (AP) remains a challenge in clinical routine. Until to date no clinical and laboratory parameter or scoring systems achieve a satisfying sensitivity. Here, we aim to investigate the role of the microbiome to predict the course and subsequent complications of AP at admission. Methods 400 patients with AP were included in the study, n> 100 with Atlanta II or III. Clinical data were collected with a standardized and GCP conformable online questionnaire. All samples were prospectively collected within the first 72h of hospital admission according to a standardized procedure Marker gene (16S rRNA) and metagenomic sequencing is conducted for buccal and rectal swab samples assessed by Oxford Nanopore sequencing technology (ONT). The microbiome data are associated with the clinical follow up. Inclusioncriteria:Patients with AP (2 out of 3 following criteria: Lipase>3x of upper limit, abdominal pain, radiological imaging correlating with AP), hospital stay< 72 hours. Exclusion criteria:pregnancy, age< 18 years . Primary endpoint: Association of revised Atlanta classification with microbiome patterns. Secondary endpoints: Length of hospital stay, mortality, infected local complications (pseudocysts or necrosis collection). Results To date, enrollment of 400 patients from 15 European centers in 7 different countries is completed. Rectal and buccal samples from more than 300 patients have been analysed and preliminary results will be presented. We will present α diversity (Observed species, Shannon index and inverse Simpson index), β diversity (weighted and unweighted UniFrac and Bray Curtis) as well as differential abundances. All metrices will be correlated to the revised Atlanta classification and more than 60 confounding variables and clinical parameters. Conclusions We aim to present first preliminary study results of P-MAPS, a European multicentric prospective study. Publication History Article published online: 19 August 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag Rüdigerstraße 14, 70469 Stuttgart, Germany

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