New approaches to acute pancreatitis: Role of inflammatory mediators

Regardless of whether the initiating event is alcohol, gallstones or some o ther less common cause, acute pancreatitis progresses in a predictable mann er eventually leading to failure of multiple unrelated organs. Very quickly following the inciting event, a local inflammatory process is initiated wh ich results in the local production of inflammatory mediators. Virtually al l patients with acute pancreatitis will experience some symptoms related to this local inflammation, with some resolving completely at this point. Mos t patients will go on to develop a systemic hyperinflammatory state express ed as the development of fever, tachycardia, tachypnea, and mild acid-base disturbances. Although this systemic hyperinflammatory state is usually mil d, occasionally it may be very severe resulting in overt distant organ fail ure. With a more thorough understanding of the inflammatory mediators respo nsible for this hyperinflammatory state, many new therapeutic approaches ar e on the horizon.