Cytokines and acute pancreatitis

Cytokines have been shown to play a pivotal role in multiple organ dysfunct ion, a major cause of death in severe acute pancreatitis. Moreover, the two -hit hypothesis of the cytokine-induced systemic inflammatory response synd rome explains the variable individual response to severe acute pancreatitis and the impact of secondary events such as sepsis or therapeutic intervent ion. Many experimental anti-cytokine therapies have been administered follo wing induction of experimental pancreatitis, and have proved to be therapeu tic. Patients with severe pancreatitis present early because of pain. Clear ly then a window for therapeutic intervention is available between onset of symptoms and peak pro-inflammatory cytokine expression. It is this fundame ntal observation that convinces many in the field that the treatment of AP will be one of the first clinical successes for novel drugs or therapy that seek to modulate the inflammatory response.