Role of Pancreatic Enzymes in Acute Pancreatitis

Abstract

Despite extensive clinical and experimental studies, the pathophysiology of acute pancreatitis is still poorly understood. Although in 80% of patients pancreatitis is associated with biliary tract disease and alcohol abuse, the precise mechanisms of induction and progression of pancreatic injury remain uncertain. There is clinical and experimental evidence that intrapancreatic activation of digestive enzymes, and the subsequent “autodigestion”, is the common underlying pathological process for damage to the pancreas in acute pancreatitis [4]. However, one of the major mysteries of this disease remains unanswered, that is, how and where, within the pancreas, do digestive enzymes become activated during pancreatitis? We are still looking for the trigger mechanism of pancreatitis. In addition, we do not know whether the cardiac, pulmonary, and renal complications during acute pancreatitis are caused by the circulating pancreatic enzymes. Alternatively, these complications might be caused by toxic substances released from the inflamed pancreas or merely be a nonspecific response of different organs to severe intraabdominal inflammation.