title: Antioxidative phytoceuticals to ameliorate pancreatitis in animal models: an answer from nature.
abstract: Despite enthusiastic efforts directed at elucidating critical underlying mechanisms towards the identification of novel therapeutic targets for severe acute pancreatitis (SAP), the disease remains without a specific therapy to be executed within the first hours to days after onset of symptoms. Although earlier management for SAP should aim to either treat organ failure or reduce infectious complications, the current standard of care for the general management of AP in the first hours to days after onset of symptoms include intravenous fluid replacement, nutritional changes, and the use of analgesics with a close monitoring of vital signs. Furthermore, repeated evaluation of severity is very important, as the condition is particularly unstable in the early stages. In cases where biliary pancreatitis is accompanied by acute cholangitis or in cases where biliary stasis is suspected, an early endoscopic retrograde cholangiopancreatography is recommended. However, practice guidelines regarding the treatment of pancreatitis are suboptimal. In chronic pancreatitis, conservative management strategies include lifestyle modifications and dietary changes followed by analgesics and pancreatic enzyme supplementation. Recently, attention has been focused on phytoceuticals or antioxidants as agents that could surpass the limitations associated with currently available therapies. Because oxidative stress has been shown to play an important role in the pathogenesis of pancreatitis, antioxidants alone or combined with conventional therapy may improve oxidative-stress-induced organ damage. Interest in phytoceuticals stems from their potential use as simple, accurate tools for pancreatitis prognostication that could replace older and more tedious methods. Therefore, the use of antioxidative nutrition or phytoceuticals may represent a new direction for clinical research in pancreatitis. In this review article, recent advances in the understanding of the pathogenesis of pancreatitis are discussed and the paradigm shift underway to develop phytoceuticals and antioxidants to treat it is introduced. Despite the promise of studies evaluating the effects of antioxidants/phytoceuticals in pancreatitis, translation to the clinic has thus far been disappointing. However, it is expected that continued research will provide solid evidence to justify the use of antioxidative phytoceuticals in the treatment of pancreatitis.
authors.affiliation: Jong-Min Park, Sooyeon Lee, Mi Kyung Chung, Sung-Hun Kwon, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA University, Seoul 135-081, South Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Park
authors.affiliation: Jong-Min Park, Sooyeon Lee, Mi Kyung Chung, Sung-Hun Kwon, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA University, Seoul 135-081, South Korea.
authors.forename: Sooyeon
authors.initials: S
authors.lastname: Lee
authors.affiliation: Jong-Min Park, Sooyeon Lee, Mi Kyung Chung, Sung-Hun Kwon, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA University, Seoul 135-081, South Korea.
authors.forename: Mi Kyung
authors.initials: MK
authors.lastname: Chung
authors.affiliation: Jong-Min Park, Sooyeon Lee, Mi Kyung Chung, Sung-Hun Kwon, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA University, Seoul 135-081, South Korea.
authors.forename: Sung-Hun
authors.initials: SH
authors.lastname: Kwon
authors.affiliation: Jong-Min Park, Sooyeon Lee, Mi Kyung Chung, Sung-Hun Kwon, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA University, Seoul 135-081, South Korea.
authors.forename: Eun-Hee
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Jong-Min Park, Sooyeon Lee, Mi Kyung Chung, Sung-Hun Kwon, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA University, Seoul 135-081, South Korea.
authors.forename: Kwang Hyun
authors.initials: KH
authors.lastname: Ko
authors.affiliation: Jong-Min Park, Sooyeon Lee, Mi Kyung Chung, Sung-Hun Kwon, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA University, Seoul 135-081, South Korea.
authors.forename: Chang Il
authors.initials: CI
authors.lastname: Kwon
authors.affiliation: Jong-Min Park, Sooyeon Lee, Mi Kyung Chung, Sung-Hun Kwon, Eun-Hee Kim, Ki Baik Hahm, CHA Cancer Prevention Research Center, CHA University, Seoul 135-081, South Korea.
authors.forename: Ki Baik
authors.initials: KB
authors.lastname: Hahm
mesh_terms: D000208:Acute Disease; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology*; D000975:Antioxidants / Q000494:pharmacology*; D004195:Disease Models, Animal; D006801:Humans; D018384:Oxidative Stress / Q000187:drug effects*; D010179:Pancreas / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D010195:Pancreatitis / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D050500:Pancreatitis, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D008517:Phytotherapy; D010936:Plant Extracts / Q000494:pharmacology*; D010946:Plants, Medicinal; D012720:Severity of Illness Index
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D010936:Plant Extracts
keywords: Acute pancreatitis; Antioxidants; Chronic pancreatitis; Phytoceuticals; Severe acute pancreatitis