Zhu et al. (2019) found that increased capacity for bacterial invasion of epithelial cells in AP correlated closely with the abundance of Escherichia-Shigella in fecal samples from 165 adults. Zheng et al. (2019) showed that commensal Escherichia coli MG1655 increases TLR4/MyD88/p38 MAPK and ERS signaling-induced intestinal epithelial injury and aggravates AP in rats. This evidence concerns the gene TLR4 and alkaline phosphatase measurement.