Clinical Gastroenterology Vol.29 No.5(1)

Theme Chronic Pancreatitis
Title Pathophysiology and Etiology of Chronic Pancreatitis
Publish Date 2014/05
Author Kyoko Shimizu Department of Internal Medicine, Institute of Gastroenterology, Tokyo Womenʼs Medical University
Author Keiko Shiratori Department of Internal Medicine, Institute of Gastroenterology, Tokyo Womenʼs Medical University
[ Summary ] Chronic pancreatitis is a progressive inflammatory disorder in which the pancreatic secretory parenchyma is destroyed and replaced by fibrous tissue, eventually leading to malnutrition, pancreatic diabetes, and local complications such as bile duct obstruction, duodenal stricture, vascular strictures, portal hypertension, or pseudocysts. The development of chronic pancreatitis results from a combination of environmental, genetic, lifestyle, and metabolic factors. Long term alcohol intake is the most important risk factor for chronic pancreatitis. Smoking is an independent risk factor for chronic pancreatitis. A combination of alcohol and smoking contributes to an increased risk of chronic pancreatitis. However less than 10 % of people who drink alcohol in excess develop this disease, suggesting that other factors interact to amplify ethanol toxicity. Recent genetic analysis has revealed that pancreatitis associated gene mutation contributes to development of chronic pancreatitis. Chronic pancreatitis is associated with loss of function mutations in genes which encode serine protease inhibitors Kazal type (SPINK1) and the cystic fibrosis transmembrane conductance regulators (CFTR). Genetic factors are known to have significant levels of association with idiopathic pancreatitis and alcoholic pancreatitis.
back