Role of cytokines and their inhibitors in acute pancreatitis.

Abstract

Leading articleRole of cytokines and their inhibitors in acute pancreatitis Acute pancreatitis is a disease with considerable lethality for which there is no specific therapy beyond supportive treatment.Epidemiological data on the disease are sparse, but the incidence in Western countries is in the region of 10-20 per 10' population.-3 There are probably up to 10 000 cases of acute pancreatitis annually in Britain and as the mortality is approximately 8-12%, overall mortality may approach 1000.In Finland the incidence has increased by 50% between 1970 and 1989.4Hospital discharges with the final diagnosis of pancreatitis correlate with alcohol consumption in men and with gallstone disease in women.The early pathophysiology of the disease is not well understood.After the initial acinar cell injury, inflamma- tory cells migrate into the interstitium by adhering to endothelium and escaping from the microcirculation.The mechanisms by which inflammatory cells adhere to endothelial cells are determined by a variety of mediators or cytokines released at sites of tissue damage.Cytokines hold the key to both the local and the systemic inflamma- tory response in acute pancreatitis.New therapeutic approaches aim to modulate these pathways.56