Acute pancreatitis

The pathophysiologic concept of acute pancreatitis focuses on early events inside acinar cells such as activation of trypsin. Despite significant prog ress in the understanding of molecular events in experimental pancreatitis, knowledge of these mechanisms has not yet been translated into therapeutic strategies useful in humans. A single morphologic or laboratory marker rel iably predicting the individual course of acute pancreatitis still awaits d iscovery. The clinical outcome of acute pancreatitis is dependent on the pr esence of necrosis and systemic complications. The extent of the systemic i nflammatory response to local pancreatitis seems to be the rate-limiting st ep. Several mechanisms shed light on the interconnectivity between intra-ac inar protease activation and immunoregulatory processes. Deciphering these cell biologic connections has already had an impact on the clinical managem ent of patients and the identification of prognostic markers in human disea se. However, further investigations of pancreatic pathophysiology are neede d to initiate novel therapeutic strategies. Curr Opin Gastroenterol 2001, 1 7:426-429 (C) 2001 Lippincott Williams & Wilkins, Inc.