Novel and Experimental Therapies in Chronic Pancreatitis

Abstract

Chronic pancreatitis (CP) is a progressive inflammatory disease of the pancreas. The currently available treatment of CP is aimed at controlling symptoms and managing complications. Unfortunately, no specific treatment is available to halt the progression of the disease process because the pathophysiological perturbations in CP are not well understood. In this review, we discuss various therapeutic targets and investigational agents acting on these targets. Among these, therapies modulating immune cells and those acting on pancreatic stellate cells appear promising and may translate into clinical benefit in near future. However, these experimental therapies are mostly in animal models and they do not recapitulate all aspects of human disease. Still they may be beneficial in developing effective therapeutic modalities to curb inflammation in chronic pancreatitis.

Thromboxane A2 receptor contributes to the activation of rat pancreatic stellate cells induced by 8-epi-prostaglandin F2α

“…Pre-clinical studies suggest that some antioxidants, including vitamin A, vitamin E, and epigallocatechin-3-gallate complex may be useful in relieving pain in CP. [ 35 – 37 ] However, the development of clinical trials based on this novel concept is limited due to various reasons. In our present study, we found that 8-epi-PGF 2α promoted PSCs activation through the up-regulation of TxA 2 r, which may provide a new target for the treatment of CP.…”

Enteric motor dysfunctions in experimental chronic pancreatitis: Alterations of myenteric neurons regulating colonic motility in rats

“…CP is regarded to be an irreversible progressive chronic inflammatory disorder associated with structural and functional damage, which is complicated by severe and constant pain in nearly half of all patients, and the classic morphological characteristics of this condition include persist inflammation, fibrosis, and destruction of the glandular pancreas . We have successfully established the TNBS‐induced CP rat models.…”

“…CP is regarded to be an irreversible progressive chronic inflammatory disorder associated with structural and functional damage, which is complicated by severe and constant pain in nearly half of all patients, 19 and the classic morphological characteristics of this condition include persist inflammation, fibrosis, and destruction of the glandular pancreas. 1 We have successfully established the TNBS-induced CP rat models. In this article, mechanical hyperalgesia and histopathological similarities to the human CP, including mono-/polymorphonuclear cell infiltrates, areas of fibrosis, duct strictures, dilated ducts, and glandular atrophy, are observed 21 days after TNBS instillation into the pancreatic ducts.…”

“…Chronic pancreatitis (CP) is a progressive inflammatory disease of the pancreas, which leads to permanent structural destruction of pancreatic parenchyma and ductal tissue, commonly manifested as paroxysmal midepigastric abdominal pain, endocrine and exocrine pancreatic insufficiency, and gastrointestinal dysmotility . The etiology of CP is complex and appears to be multi‐factorial, including environmental factors such as intake of alcohol; smoking; and genetic, anatomic, and obstructive abnormalities .…”

Recent advances in the diagnosis and management of chronic pancreatitis

“…Islet cell graft function is seen in at least 80% of cases, while escape from insulin therapy is observed in one-third of patients and has been observed for more than 15 years [97]. However, success rates vary widely among reports depending on various technical factors, injection method, implantation site, and number of cells to be injected [98]. Therefore, it is preferable that a multidisciplinary team performs the procedure at a more specialized center.…”