Chronic Pancreatitis with Fibrogenesis

Yoo, Byung Moo

Abstract

Chronic pancreatitis is an ongoing inflammatory disorder characterized by irreversible destruction of the pancreas associated with disabling chronic pain and permanent loss of exocrine and endocrine function. Fibrosis and loss of acinar cell mass in the pancreas are characteristic findings in chronic pancreatitis, and pancreatic fibrosis is suggested to contribute to the irreversibility of the disease Over the past several decades, several theories have emerged to explain the pathogenesis and evolution of pancreatitis. These models provide conceptual frameworks that are not mutually exclusive, but at times are mutually contradictory. The role of pancreatic fibrogenesis in response to various forms of pancreatic injury and the relationship of fibrogenesis in response to the progression from acute to chronic form is emphasized within the sentinel acute pancreatitis event (SAPE) model of chronic pancreatitis. Studies on pancreatic fibrogenesis have been given new impetus, largely because of the identification and characterization of stellate-shaped cells in the pancreas. In the normal pancreas, pancreatic stellate cells (PSC) exist in a quiescent state. However in pancreatic injury, the PSCs are activated so that they exhibit increased proliferation, transformation onto myofibroblast-like cells and synthesize increased amounts of the extracellular matrix proteins that form fibrous tissues. Therefore, the PSCs have a central role in pancreatic fibrogenesis. Over the past several decades, the pathogenesis of chronic pancreatitis has been studied. However, the pathogenesis of chronic pancreatitis is unclear. Therefore, further studies would be needed to clarify the pathogenesis of chronic pancreatitis..