Immune-modulating therapy in acute pancreatitis: fact or fiction.
Acute pancreatitis (AP) is one of the most common diseases of the gastrointestinal tract, bearing significant morbidity and mortality worldwide. Current treatment of AP remains unspecific and supportive and is mainly targeted to aggressively prevent systemic complications and organ failure by intensive care. As acute pancreatitis shares an indistinguishable profile of inflammation with sepsis, therapeutic approaches have turned towards modulating the systemic inflammatory response. Targets, among others, have included pro- and anti-inflammatory modulators, cytokines, chemokines, immune cells, adhesive molecules and platelets. Even though, initial results in experimental models have been encouraging, clinical implementation of immune-regulating therapies in acute pancreatitis has had a slow progress. Main reasons include difficulty in clinical translation of experimental data, poor understanding of inflammatory response time-course, flaws in experimental designs, need for multimodal approaches and commercial drawbacks. Whether immune-modulation in acute pancreatitis remains a fact or just fiction remains to be seen in the future.
Karolina Akinosoglou, Charalambos Gogos, Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, 26504 Rio, Greece.
Karolina
K
Akinosoglou
Karolina Akinosoglou, Charalambos Gogos, Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, 26504 Rio, Greece.
Charalambos
C
Gogos
D000208:Acute Disease; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000627:therapeutic use*; D018836:Inflammation Mediators / Q000037:antagonists & inhibitors / Q000276:immunology / Q000378:metabolism; D058990:Molecular Targeted Therapy; D010195:Pancreatitis / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D007155:Immunologic Factors; D018836:Inflammation Mediators
Acute pancreatitis; Endoscopic retrograde cholangiopancreatography; Immune-modulation; Multiple organ dysfunction syndrome; Systemic inflammatory response syndrome