Kallikrein-kinin system in acute pancreatitis: Potential of B-2-bradykininantagonists and kallikrein inhibitors

The development of selective antagonists for bradykinin B-2 receptors has g reatly advanced research on the role of the kallikrein-kinin system in acut e pancreatitis. Kinins released du ring the course of the inflammatory inju ry are the major cause of the vascular symptoms, i.e. pancreatic oedema for mation and its consequences, such as haemoconcentration, hypovolaemia and h ypotension. Kinins are also involved in the accumulation of potentially cyt otoxic factors in the pancreatic tissue. However, treatment with B-2 antago nists must begin prior to the formation of pancreatic oedema in order to in hibit or attenuate the vascular effects. Visceral pain as a possible target symptom for treatment with B-2 antagonists at later time points is suggest ed by the B-2 receptor-mediated activation of nociceptive afferents, Copyri ght (C) 2000 S. Karger AG, Basel.