Immunonutrition and Nutritional Support in Pancreatic Cancer, Pancreatitis, and Hepatobiliary Diseases

Pancreatic and hepatobiliary diseases are frequently associated with profound metabolic disturbances, systemic inflammation, and a high burden of malnutrition, all of which significantly influence clinical outcomes. Among these conditions, pancreatic cancer represents a particularly complex and devastating entity, in which nutritional impairment is both a consequence of disease pathophysiology and a determinant of prognosis. Acute and chronic pancreatitis, as well as cholestatic and cirrhotic hepatobiliary disorders, similarly contribute to nutritional decline through impaired digestion, absorption, and hepatic metabolic regulation.The pancreas plays a central role in digestion and glycemic control; consequently, pancreatic cancer and pancreatitis frequently lead to both exocrine and endocrine insufficiency. Disturbances in digestion contribute to malnutrition in up to 80% of patients, often manifesting as weight loss driven by malabsorption, reduced dietary intake, abdominal pain, nausea, and psychological distress, including anxiety and depression.Tumor-related complications further aggravate nutritional deterioration. Local tumor infiltration or compression may lead to duodenal or gastric obstruction, resulting in vomiting and impaired oral intake. In tumors of the pancreatic head, bile duct obstruction can cause jaundice, impairing fat digestion and absorption of fat-soluble vitamins, while pancreatic duct obstruction further compromises macro- and micronutrient absorption.Advanced cholestasis and jaundice may lead to liver dysfunction with profound systemic consequences. Impaired hepatic function disrupts protein synthesis, glucose metabolism, and lipid homeostasis, contributing to hypoalbuminemia, insulin resistance, and altered energy balance. Liver dysfunction also affects the metabolism and clearance of nutrients, drugs, and inflammatory mediators, amplifying systemic inflammation and immune dysregulation. These changes promote muscle wasting, sarcopenia, and the progression of cancer-related cachexia. Many patients develop cancer anorexia–cachexia syndrome (CACS), characterized by anorexia, fatigue, weight loss, and systemic inflammation — a condition strongly associated with poor prognosis. Standard oncological treatments, including surgery, chemotherapy, and radiotherapy, further increase the risk of nutritional and metabolic deterioration.We welcome Original Research and Reviews addressing, but not limited to, the following themes:o Mechanistic studies on immunonutrient pathways (arginine, glutamine, omega-3 PUFAs, nucleotides) in pancreatic and hepatobiliary diseaseo Perioperative immunonutrition and Enhanced Recovery After Surgery (ERAS) protocols in pancreatic and hepatobiliary surgeryo Cancer anorexia–cachexia syndrome (CACS), sarcopenia, and muscle wasting in pancreatic and hepatobiliary malignancieso Nutritional management of acute and chronic pancreatitis, cirrhosis-related malnutrition, and cholestatic disorderso The gut–liver–pancreas axis, microbiota–immune interactions, and microbiota-targeted nutritional interventionso Pancreatic enzyme replacement therapy (PERT) and its impact on nutritional and clinical outcomeso Early nutritional screening, assessment tools, and intervention pathways in clinical practiceo Personalized and biomarker-driven nutrition strategies for improving treatment tolerance and prognosiso Multidisciplinary care models integrating nutritional support into oncology, hepatology, and surgical practiceo Translational and clinical studies on enteral, parenteral, and oral nutritional supplementation Topic editors: Beata Jabłońska, Mats Lukas Wiese Source: https://www.frontiersin.org/research-topics/84467/immunonutrition-and-nutritional-support-in-pancreatic-cancer-pancreatitis-and-hepatobiliary-diseases