Clinical and translational markers of severity and prognosis in chronic pancreatitis

Abstract

Purpose of reviewThe incidence of chronic pancreatitis as a progressive inflammation and fibrosis syndrome is on the rise due to increasing awareness and improved imaging modalities. Numerous classification systems have been suggested in recent years to describe the disease, but only few of them have been used to classify the severity and prognostic significance of the disease. Biomarkers for severity and (early) chronic pancreatitis diagnosis are not yet ready for clinical application.Recent findingsIn using the M-ANNHEIM and Chronic Pancreatitis Prognosis Score (COPPS) classification system, the severity assessment and short- and medium-term disease progression is available. A prospectively validated biomarker for early chronic pancreatitis diagnosis is not yet available, metabolome-based approaches seem to have the greatest potential for clinical translation.SummaryCurrently, due to the lack of universal definition for the early disease stage of chronic pancreatitis, it is difficult to accurately classify these patient cohorts in existing scoring systems. In principle, setting up a suitable scoring system would allow surveillance and establish a therapy approaches flanked by corresponding biomarker panel development. Therapy management of chronic pancreatitis and monitoring by means of scoring systems (such as the COPPS) would make a decisive contribution to improving patient treatment.

The Kruppel-like factor 4-signal transducer and activator of transcription 5A axis promotes pancreatic fibrosis in mice with caerulein-induced chronic pancreatitis

“…tumor necrosis factor-alpha (TNF-α) and some interleukins (ILs)] produced by infiltrating inflammatory cells, can transform pancreatic stellate cells from fat-storing cells to myofibroblast-like cells, leading to fibrosis [3,4]. The incidence and prevalence of CP is rising due to increasing awareness and improved imaging modalities and no curative treatment is available [5,6]. For this reason, it remains necessary to explore novel molecular biomarkers for PF to extend treatment options for PF.…”