Editorial
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 7, 2008; 14(41): 6273-6275
Published online Nov 7, 2008. doi: 10.3748/wjg.14.6273
Prediction of severe acute pancreatitis: Current knowledge and novel insights
Georgios I Papachristou
Georgios I Papachristou, Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh PA 15213, United States
Author contributions: Papachristou GI wrote the paper.
Correspondence to: Georgios I Papachristou, MD, Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, GI Administration, Mezzanine Level 2, C Wing, UPMC Presbyterian Hospital, 200 Lothrop Street, Pittsburgh PA 15213, United States. papachri@pitt.edu
Telephone: +1-412-6478132 Fax: +1-412-3837236
Received: April 21, 2008
Revised: July 20, 2008
Accepted: July 27, 2008
Published online: November 7, 2008
Abstract

Acute pancreatitis (AP) is a common and potentially lethal acute inflammatory process with a highly variable clinical course. It is still unclear why some patients progress to organ failure and others do not. Ability to predict which patients will develop severe disease is limited. Routine clinical and laboratory data and multi-factorial clinical scores measured on admission and during the first 48 h of hospitalization are currently the standards of care used to estimate the magnitude of the inflammatory response to injury. Current literature highlights several common environmental, metabolic and genetic factors that increase the risk of AP development and subsequent adverse sequelae. Several cytokines have been found to play a critical role in the pathogenesis of AP by driving the subsequent inflammatory response, to include tumor necrosis factor-α (TNF-α), Interleukin-1 (IL-1), IL-6 and monocyte chemotactic protein-1 (MCP-1). Large, prospective studies are still needed to address these questions by identifying AP risk factors and serum biomarkers of severe disease.

Keywords: Acute pancreatitis; Prediction; Severity; Monocyte chemotactic protein-1