Publication Name	World Journal of Gastroenterology
Manuscript ID	122664
DOI	10.3748/wjg.122664
Country	China

Category	Gastroenterology & Hepatology
Manuscript Type	Review
Article Title	Endogenous metabolites as active drivers of acute pancreatitis: Mechanisms and advances in targeted therapy
Manuscript Source	Unsolicited Manuscript
All Author List	Xiang Lu, Yu Zeng, Li Li, Jian-Qin Liu, Xin Zhou, Xiao-Ning Jin, Chao-Li Jiang and Zhi Li
Funding Agency and Grant Number	Funding Agency Grant Number Science and Technology Project of Sichuan Administration of Traditional Chinese Medicine No. 2024zd035 Sichuan University and Luzhou Municipal People’s Government Strategic cooperation projects No. 2020CDLZ-18 Southwest Medical University Technology Program No. 2023ZYQJ03
Corresponding Author	Zhi Li, Academic Fellow, Chief Physician, MD, PhD, Professor, Department of Spleen and Stomach Diseases, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, No. 182 Chunhui Road, Longmatan District, Luzhou 646000, Sichuan Province, China. lizhi-scholar@swmu.edu.cn
Key Words	Acute pancreatitis; Metabolic network; Metabolomics; Targeted therapy; Drug repurposing; Mitochondrial dysfunction; Gut microbiota
Core Tip	Acute pancreatitis still has no therapy directed at its core mechanisms, and treatment remains supportive. Metabolomic studies have revealed widespread disturbance of metabolic pathways during the disease, and accumulating evidence indicates that these changes are not merely markers but active contributors to acinar injury, inflammatory amplification, and immune dysregulation. This review classifies the relevant metabolites by origin host enzymes, gut microbes, or the cooperation of both and examines eight pathways together with the interventions being tested for each. It treats the mitochondrion as a point where several injurious pathways converge and the gut as a source of metabolites that act on the pancreas from a distance. Because the contribution of each pathway shifts as the disease evolves, it also considers how interventions might be matched to the disease phase. As the evidence is still largely preclinical, the framework is meant to guide further study rather than current treatment.
Citation	Lu X, Zeng Y, Li L, Liu JQ, Zhou X, Jin XN, Jiang CL, Li Z. Endogenous metabolites as active drivers of acute pancreatitis: Mechanisms and advances in targeted therapy. World J Gastroenterol 2026; In press DOI: https://doi.org/10.3748/wjg.122664
PDF	122664-in-press.pdf

Received	2026-04-27 06:13
Peer-Review Started	2026-04-27 06:14
First Decision by Editorial Office Director	2026-06-09 09:40
Return for Revision	2026-06-09 09:40
Revised	2026-06-22 17:52
Publication Fee Transferred	2026-06-30 09:52
Second Decision by Editor	2026-08-27 02:44
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-08-28 09:19
Articles in Press	2026-08-28 09:19
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1007-9327 (print) and 2219-2840 (online)
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