Korean Journal of Pancreas and Biliary Tract  2015;20(3):115-123

doi:10.15279/kpba.2015.20.3.115

Mechanism of Severe Acute Pancreatitis: Focusing on Development and Progression.

Jae Hyuk DO 1

Affiliations

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Keywords

Severe acute pancreatitis; Pathogenesis; Organ failure; Pancreatic infection

Country

Republic of Korea

Language

English

Abstract

Acute pancreatitis (AP) is an inflammatory disorder and the severity range from mild to severe form. The mortality of severe form of AP is still high despite of tremendous improvement of diagnostic modalities and therapeutic options. Although pathogenesis of AP is still not fully understood, autodigestion theory is regarded as an initial common pathophysiologic mechanism of AP for about 2 centuries. However, it is obscure which mechanisms are involving the disease severity. Upregulation of adhesion molecules, leukocytes, proinflammatory cytokines and chemokines are also concerned local injury, systemic exacerbation of inflammation and ultimately organ failure. In addition, transcription factor Nuclear factor-kappa B is also influence the severity through upregulate the proinflammatory genes. The patterns of acinar cell death are closely correlated with disease severity of AP. The degree of acinar cell apoptosis is reversed correlated whereas necrotic cell death is proportionate to severity.