Diabetes and the Pancreatobiliary Diseases

Acute pancreatitis is an inflammatory disorder of the exocrine pancreas associated with tissue injury and necrosis. The disease can be mild, involving only the pancreas, and resolve spontaneously within days or severe, with systemic inflammatory response syndrome- associated extrapancreatic organ failure and even death. Importantly, there are no therapeutic agents currently in use that can alter the course of the disease. This article emphasizes emerging findings that stressors (environmental and genetic) that cause acute pancreatitis initially cause injury to organelles of the acinar cell (endoplasmic reticulum, mitochondria, and endolysosomal–autophagy system), and that disorders in the functions of the organelles lead to inappropriate intracellular activation of trypsinogen and inflammatory pathways. We also review emerging work on the role of damage-associated molecular patterns in mediating the local and systemic inflammatory response in addition to known cytokines and chemokine pathways. In the review, we provide considerations for correction of organelle functions in acute pancreatitis to create a discussion for clinical trial treatment and design options.

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“…4 Of note, recent literature also associates diabetes with an increased risk for development of pancreatitis. 27–29…”

Section: Acute Pancreatitis: a Disorder With Different Causes Requirimentioning

confidence: 99%

Acute Pancreatitis: A Multifaceted Set of Organelle and Cellular Interactions

2019

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“…In addition to gallstones, women are more likely to have acute pancreatitis due to complications of endoscopic retrograde cholangiopancreatography (ERCP) or an autoimmune cause and are more likely to have idiopathic acute pancreatitis 1. Recent literature suggests that diabetes is associated with a small increase in risk for development of pancreatitis 456…”

Section: Epidemiologymentioning

confidence: 99%

Management of severe acute pancreatitis

Hines

Pandol

2019

BMJ

117

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The risks, measurements of severity, and management of severe acute pancreatitis and its complications have evolved rapidly over the past decade. Evidence suggests that initial goal directed therapy, nutritional support, and vigilance for pancreatic complications are best practice. Patients can develop pancreatic fluid collections including acute pancreatic fluid collections, pancreatic pseudocysts, acute necrotic collections, and walled-off necrosis. Several randomized controlled trials and cohort studies have recently highlighted the advantage of managing these conditions with a progressive approach, with initial draining for infection followed by less invasive techniques. Surgery is no longer an early intervention and may not be needed. Instead, interventional radiologic and endoscopic methods seem to be safer with at least as good survival outcomes. Newly developed evidence based quality indicators are available to assess and improve performance. Development and clinical testing of drugs to target the mechanisms of disease are necessary for further advancements.

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“…In this study, the patients and controls were found to have similar rates of DM. However, this comorbidity is an important factor in carcinogenesis (Shafqet et al, 2017) in that hyperinsulinemia stimulates greater expression of type 1 insulin-like growth factor (IGF-1) and insulin receptors via PI3K/Akt/mTOR signaling, thus triggering proliferation, angiogenesis, metastasis, and inhibition of apoptosis (Wojciechowskaet al, 2016;Labibet al, 2019;Clements et al, 2020). It is important to note that our sample contained a majority of women; however, the global incidence of DM among men has risen in recent decades (NCD Risk Factor Collaboration, 2016).…”

Section: Discussionmentioning

confidence: 99%

Underexpression of miR-126-3p in Patients with Cholangiocarcinoma

Spinola

Vieira

Ferreira

et al. 2021

Asian Pac J Cancer Prev

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Cholangiocarcinoma (CCA) is the second most common primary liver cancer after hepatocellular carcinoma (HCC), accounting for 10% to 15% of primary liver malignancy. CCA is formed in the epithelial tissue that makes up the biliary tract and is classified into three anatomical subtypes: intrahepatic carcinoma (iCCA), perihilar carcinoma (pCCA), and distal carcinoma (dCCA) (Khan et al., 2019;Massironi et al., 2020).Viral infections, primary sclerosing cholangitis, biliary lithiasis, congenital malformations, cirrhosis of the liver, and hepatobiliary parasite infections have been found to be risk factors for CCA (Khan et al., 2019). Lifestyle habits, such as alcoholism and smoking, as well as comorbidities, namely diabetes mellitus (DM), also contribute to the risk of CCA (Brandi et al., 2020).

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Diabetes and the Pancreatobiliary Diseases

Cited by 14 publications

References 48 publications

Acute Pancreatitis: A Multifaceted Set of Organelle and Cellular Interactions

Acute Pancreatitis: A Multifaceted Set of Organelle and Cellular Interactions

Management of severe acute pancreatitis

Underexpression of miR-126-3p in Patients with Cholangiocarcinoma

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