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. 2022 Mar 3;13:844401. doi: 10.3389/fimmu.2022.844401

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Copyright © 2022 Chen, Zhang, Dong, Xu and Zhou

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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The pathways the microbiota migrates to the pancreatic tissue. Transduodenal papillary reflux pathway: The pancreas is connected to the oral cavity, esophagus, and stomach upward through the pancreatic duct, downward to the duodenum, and adjacent to the common bile duct. These features suggest the possibility of microbiota reflux into the pancreatic duct and then into the pancreatic parenchyma through the large/little papillae. Translymphatic circulation pathway: The microbiota distant from the pancreas (such as in the colon) enters the MLN by chance and is phagocytized by mononuclear phagocytes (e.g. CX3CR1⁺ cells) or DCs, and instead of being lysed, these opportunistic pathogens are fortunately transferred to the pancreatic tissue for reproduction via the lymphatic system. Transcirculatory pathway: The microbiota far away from the pancreas (such as in the colon) enters the blood under pathological conditions (such as damage to the intestinal barrier caused by colitis), and colonizes other organs, including pancreatic tissue, along with the blood circulation.