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Between early and established chronic pancreatitis: A proposal of “acinar-ductal hybrid mechanism” by Tooru Shimosegawa is a Medicine article available to read on EtoBox.

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Background/objectives: The recently proposed "new mechanistic definition of chronic pancreatitis (CP)" categorized early CP as a reversible condition. However, there is no clear explanation regarding the pathological condition of early CP, the reason for the development of the disease in only a small portion of the patients with risk factors, and the mechanism for transition from a reversible pathological condition to an irreversible one. Methods: Based on the available information, a mechanism that could provide answers to the queries associated with CP was proposed. Results: Acinar-ductal coordination is very important for the physiological secretion of pancreatic juice. Inflammation originating from acinar cells undermines the function of proximal ducts and leads to a vicious cycle of sustained inflammation by increasing the viscosity and decreasing the alkalinity of pancreatic juice. Persistent elevation of ductal pressure due to stagnation of pancreatic juice caused by protein plugs, stones, or fibrous scar of ducts converts the reversible pathological condition of early CP to an irreversible one. Diagnostic criteria for early CP proposed by Japanese researchers have enabled t

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Author

Tooru Shimosegawa

Publisher

Elsevier BV

Published

2022

Language

EN

Field

Medicine (Health Sciences)