Academic Pancreas Centers of Excellence: Guidance from a multidisciplinary chronic pancreatitis working group at PancreasFest

Sheth, Sunil G.; Conwell, Darwin L.; Whitcomb, David C.; Alsante, Matthew; Anderson, Michelle A.; Barkin, Jamie S.; Brand, Randall E.; Coté, Gregory A.; Freedman, Steven D.; Gelrud, Andrés; Gorelick, Fred S.; Lee, Linda; Morgan, Katherine A.; Pandol, Stephen J.; Singh, Vikesh K.; Yadav, Dhiraj; Wilcox, C. Mel; Hart, Phil A.

doi:10.1016/j.pan.2017.02.015

Cited by 27 publications

(18 citation statements)

References 91 publications

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“…DM onset generally develops many years following disease onset, and may ultimately affect up to 80% of patients during their lifetime 45 . Due to the high prevalence of CP-DM annual screening for DM is recommended 46,47 . A recent study of 1,171 subjects with CP demonstrated that DM was more likely to occur in subjects who were older, obese, male sex, black race, or with a family history of DM, while factors independently associated with DM included both obesity and the presence of exocrine pancreatic insufficiency (EPI) 43 .…”

Section: Chronic Pancreatitis-related Diabetes Mellitusmentioning

confidence: 99%

Chronic Pancreatitis: Managing a Difficult Disease

Hart

Conwell

2019

Am J Gastroenterol

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Chronic pancreatitis (CP) is characterized by progressive, irreversible morphologic and functional changes that are most commonly attributed to environmental insults, particularly when there is a genetic or anatomic predisposition. Heavy alcohol use and cigarette smoking are the most common environmental risk factors, but both may be absent. Antecedent episodes of acute pancreatitis occur in about half of patients, so active interventions are needed to reduce the risk of disease progression. Abdominal pain is the most common symptom, and requires a tailored approach depending on the anatomic changes in the pancreas. Other clinical manifestations include diabetes mellitus, exocrine pancreatic insufficiency, metabolic bone disease, pancreatic cancer, and anatomic complications. Current disease management is centered on risk factor reduction, and screening for and treating disease complications. There are no current therapies to delay or retard disease progression, but there are ongoing efforts to more fully understand the natural history of CP and underlying mechanisms of disease. These studies are expected to provide insights that will transform our approach to disease management and provide further hope to patients.

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Section: Chronic Pancreatitis-related Diabetes Mellitusmentioning

confidence: 99%

Chronic Pancreatitis: Managing a Difficult Disease

Hart

Conwell

2019

Am J Gastroenterol

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“…Pancreatitis is an inflammatory disease of the pancreas and divided into acute and chronic pancreatitis. Chronic pancreatitis (CP) is characterized by irreversible inflammatory disorders that leading to fibrotic destruction of pancreatic parenchyma, endocrine, and exocrine dysfunction ( Sheth et al, 2017 ). CP develops due to repeated episodes of acute pancreatitis (AP) resulting in the activation of pancreatic stellate cells (PSCs); thus fibrosis ( Beyer et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Saikosaponin D Attenuates Pancreatic Injury Through Suppressing the Apoptosis of Acinar Cell via Modulation of the MAPK Signaling Pathway

Cui

Zhang

et al. 2021

Front. Pharmacol.

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Chronic pancreatitis (CP) is a progressive fibro-inflammatory syndrome. The damage of acinar cells is the main cause of inflammation and the activation of pancreatic stellate cells (PSCs), which can thereby possibly further aggravate the apoptosis of more acinar cells. Saikosaponind (SSd), a major active ingredient derived from Chinese medicinal herb bupleurum falcatum, which exerted multiple pharmacological effects. However, it is not clear whether SSd protects pancreatic injury of CP via regulating the apoptosis of pancreatic acinar cells. This study systematically investigated the effect of SSd on pancreatic injury of CP in vivo and in vitro. The results revealed that SSd attenuate pancreatic damage, decrease the apoptosis and suppress the phosphorylation level of MAPK family proteins (JNK1/2, ERK1/2, and p38 MAPK) significantly in the pancreas of CP rats. In addition, SSd markedly reduced the apoptosis and inflammation of pancreatic acinar AR42J cells induced by cerulein, a drug induced CP, or Conditioned Medium from PSCs (PSCs-CM) or the combination of PSCs-CM and cerulein. Moreover, SSd significantly inhibited the activated phosphorylation of JNK1/2, ERK1/2, and p38 MAPK induced by cerulein or the combination of PSCs-CM and cerulein in AR42J cells. Furthermore, SSd treatment markedly decreased the protein levels of p-JNK and p-p38 MAPK caused by PSCs-CM alone. In conclusion, SSd ameliorated pancreatic injury, suppressed AR42J inflammation and apoptosis induced by cerulein, interrupted the effect of PSCs-CM on AR42J cells inflammation and apoptosis, possibly through MAPK pathway.

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“…DM usually occurs several years after the onset of the disease and can eventually affect up to 80% of patients over their lifespan [69]. Due to the high prevalence of CP-DM, annual screening for DM is recommended [70,71]. In a recent study of participants with CP, DM was more likely to occur in participants who were older, obese, male, black race, or had a family history of DM and factors independently associated with DM included both obesity and the presence of exocrine pancreatic insufficiency [72].…”

Section: Clinical Presentationmentioning

confidence: 99%

“…In other gastrointestinal conditions, such as celiac disease, cholestatic liver disease, and inflammatory bowel disease, baseline screening with a DEXA scan has been widely adopted. That is why, baseline screening with DEXA in CP is reasonable considering that CP has higher odds of fractures compared with other gastrointestinal conditions [67,71].…”

Section: Treatment Of Metabolic Bone Disordermentioning

confidence: 99%

“…While PDAC screening is not routinely recommended, it is advised to retain high clinical suspicion in those with unexplained symptoms, such as unexplained weight loss or changes in abdominal pain characteristics [1,71]. In all patients with chronic pancreatitis, newly diagnosed diabetes may be an early sign of pancreatic cancer and may prompt further research.…”

Section: Cp and Pancreatic Cancer Surveillancementioning

confidence: 99%

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Current Approaches in Chronic Pancreatitis

Saka¹,

Boynukara²,

Çadırcıbaşı³

et al. 2022

Recent Advances in Pancreatitis

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Chronic pancreatitis is a fibroinflammatory syndrome of the pancreas that results in exocrine and endocrine pancreatic insufficiency and chronic pain. It can be seen in all age groups depending on the etiologic factors. It is believed that alcohol is one of the major etiologic factors of chronic pancreatitis, but it is now recognized that alcohol is responsible for 50% of the cases. Mutations in many genes such as PRSS1, SPINK1, CTRC, CFTR are identified as causative or predisposing factors for CP. Early diagnosis and staging of CP are still a challenge in clinic. Although the chief complaint of patients with CP is abdominal pain, CP can cause many disorders such as diabetes or metabolic bone diseases. The treatment of CP mainly depends on the severity of the disease and morphology of the pancreas. Medical therapy, endoscopy and surgery are all used for the treatment of CP and its complications.

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Academic Pancreas Centers of Excellence: Guidance from a multidisciplinary chronic pancreatitis working group at PancreasFest

Cited by 27 publications

References 91 publications

Chronic Pancreatitis: Managing a Difficult Disease

Chronic Pancreatitis: Managing a Difficult Disease

Saikosaponin D Attenuates Pancreatic Injury Through Suppressing the Apoptosis of Acinar Cell via Modulation of the MAPK Signaling Pathway

Current Approaches in Chronic Pancreatitis

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