ANTIOXIDANTS IN HEREDITARY PANCREATITIS

Objective: The cause of hereditary pancreatitis (HP) remains unknown. This study evaluated the hypothesis that patients with HP have genetic ally determined low concentrations of antioxidants that may predispose them to repetitive pancreatic injury. Methods: This cross-sectional a nalysis compared antioxidant levels in four groups of patients. Group 1 included 14 related people with chronic pancreatitis. Group 2 (11 in dividuals) belonged to the same kindred but did not have pancreatitis. Group 3 was a group of 65 unrelated control subjects, and Group 4 con sisted of seven unrelated children with chronic pancreatitis from othe r causes. The antioxidant levels analyzed included glutathione peroxid ase, superoxide dismutase, glutathione reductase, glutathione transfer ase, selenium, and vitamin E. Amylase levels were measured in all pati ents in groups 1, 2, and 4. Results: People with chronic pancreatitis or relatives of people with hereditary pancreatitis (groups 1, 2, and 4) had significantly lower mean glutathione peroxidase values than con trols (group 3,p < 0.001). Group 1 also had significantly lower seleni um levels than groups 2 and 3 (p < 0.001) but greater levels than grou p 4 (p = 0.029). Vitamin E levels were lower in group 1 than in groups 2 and 4. The superoxide dismutase levels were significantly different between each group (p < 0.001), and group 1 had the highest level. Th e glutathione reductase glutathione transferase, and amylase levels di d not differ significantly between groups. However, group 1 had a sign ificantly higher glutathione transferase level than group 4. Conclusio n: We identified antioxidant deficiencies in a group of patients with hereditary pancreatitis. Higher selenium and vitamin E levels may have prevented their relatives in group 2 from having pancreatitis seconda ry to oxidant injury, despite low glutathione peroxidase levels. Suppl ementation with selenium or vitamin E or both may be a beneficial ther apeutic option in these patients to decrease the frequency of pancreat itis.