Commentaries

A novel role for leucocytes in determining the severity of acute pancreatitis

Julia Mayerle

Department of Medicine A, Ernst-Moritz-Arndt-University Greifswald, Germany

Correspondence to:
^{Correspondence to} Professor Julia Mayerle, Department of Medicine A, Ernst-Moritz-Arndt-University, Greifswald, Friedrich-Loeffler-Str 23a, 17475 Greifswald, Germany; mayerle@uni-greifswald.de

The first 150 words of the full text of this article appear below.

For more than a century autodigestion has been regarded as the principal mechanism underlying pancreatitis.¹ The modern version of this concept implies that a premature and intrapancreatic activation of pancreatic proteases occurs very early in the disease, and then overwhelms a multitude of protective mechanisms that physiologically prevent or inhibit digestive enzymes activity outside the small intestine.² Novel treatments that target protease activity have, unfortunately, not been shown to be consistently beneficial in clinical pancreatitis. This is probably because they either target the wrong proteases or because they are administered too late in the disease process.³

Another line of experimental evidence suggests that, while initial protease activation may be a triggering event, the ultimate disease severity depends on the balance between pro- and anti-inflammatory responses of the affected patient and cellular and humoral factors have been shown to be involved in the process.⁴ While activities of pancreatic enzymes in the . . . [Full text of this article]

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