Document Detail

Differential roles of inflammatory cells in pancreatitis.
MedLine Citation:
PMID:  22320916     Owner:  NLM     Status:  In-Data-Review    
The incidence of acute pancreatitis per 100 000 of population ranges from 5 to 80. Patients suffering from hemorrhagic-necrotizing pancreatitis die in 10-24% of cases. 80% of all cases of acute pancreatitis are etiologically linked to gallstone disease immoderate alcohol consumption. As of today no specific causal treatment for acute pancreatitis exists. Elevated C-reactive protein levels above 130 mg/L can also predict a severe course of acute pancreatitis. The essential medical treatment for acute pancreatitis is the correction of hypovolemia. Prophylactic antibiotics should be restricted to patients with necrotizing pancreatitis, infected necrosis or other infectious complications. However, as premature intracellular protease activation is known to be the primary event in acute pancreatitis. Severe acute pancreatitis is characterized by an early inflammatory immune response syndrome (SIRS) and a subsequent compensatory anti-inflammatory response syndrome (CARS) contributing to severity as much as protease activation does. CARS suppresses the immune system and facilitates nosocomial infections including infected pancreatic necrosis, one of the most feared complications of the disease. A number of attempts have been made to suppress the early systemic inflammatory response but even if these mechanisms have been found to be beneficial in animal models they failed in daily clinical practice.
Julia Mayerle; Annegret Dummer; Mathias Sendler; Sudarshan Ravi Malla; Cindy van den Brandt; Steffen Teller; Ali Aghdassi; Claudia Nitsche; Markus M Lerch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of gastroenterology and hepatology     Volume:  27 Suppl 2     ISSN:  1440-1746     ISO Abbreviation:  J. Gastroenterol. Hepatol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607909     Medline TA:  J Gastroenterol Hepatol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  47-51     Citation Subset:  IM    
Copyright Information:
© 2012 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Department of Medicine A, University Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany.
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