Chronic pancreatitis

Darwin L. Conwell, Peter A. Banks

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

Purpose of review. This timely review will focus on clinical and basic science studies that have greatly advanced our knowledge of the molecular mechanisms of both acute pancreatitis and chronic pancreatitis over the last year. Recent findings. Animal models of both severe acute pancreatitis and chronic pancreatitis have recently been developed. Several unexpected protective mechanisms, mediated by the protease activated receptor 2 and heat shock protein 70, have been described. A genetic study suggested that polymorphisms in toll-like receptor-4 might affect the risk of developing infections in acute pancreatitis. Studies of chronic pancreatitis have shown that specific neural receptors, transient receptor potential vanilloid subtype 1, mediate pain responses in a model of chronic pancreatitis. The pancreatic zymogen, chymotrypsin C, can degrade pathologically activated trypsin in the acinar cell. Inactivating mutations in chymotrypsin C have been reported to predispose to the development of chronic pancreatitis, especially in those who are prone to alcohol abuse. Summary. In 2007, major advances were made in our understanding of central processing in chronic pancreatitis pain. New techniques are being utilized in search of a better means to diagnose early chronic pancreatitis. Important prospective studies are emerging, which compare endoscopic and surgical interventions. Furthermore, the complexities of diagnosing autoimmune pancreatitis are being recognized. Overall, the future is promising as advances in genomic and proteomic techniques are applied to improve our understanding of chronic pancreatitis.

Original languageEnglish
Pages (from-to)586-590
Number of pages5
JournalCurrent Opinion in Gastroenterology
Volume24
Issue number5
DOIs
StatePublished - Sep 2008

Keywords

  • Autoimmune pancreatitis
  • Biomarkers
  • Central sensitization
  • Chronic pancreatitis
  • Cortical reorganization
  • Elastography
  • Lithotripsy
  • Proteomics
  • Smoking
  • Stellate cells

ASJC Scopus subject areas

  • Gastroenterology

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