Nutrition Management in Acute Pancreatitis

Ramanathan, Meera; Aadam, A. Aziz

doi:10.1002/ncp.10386

Cited by 25 publications

(34 citation statements)

References 49 publications

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“…The occurrence and development of acute pancreatitis (AP) have been the focus of research in the field of surgery (1). The condition of AP, especially severe acute pancreatitis (SAP), is dangerous and has a high mortality rate (2).…”

Section: Introductionmentioning

confidence: 99%

CircHIPK3 Promotes Pyroptosis in Acinar Cells Through Regulation of the miR-193a-5p/GSDMD Axis

Wang

Liu

et al. 2020

Front. Med.

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Acute pancreatitis (AP), especially severe acute pancreatitis (SAP), is an extremely dangerous illness with a high mortality rate. Pyroptotic cells release their cellular contents and inflammatory factors, aggravating the inflammatory response. Pyroptosis may be the main mode of acinar cell death during AP. The circular RNA circHIPK3 is expressed in pancreatic tissue and is associated with inflammatory response. In this study, we focused on the role and underlying mechanism of circHIPK3 in AP. We found that the expression of circHIPK3 was significantly elevated in serum of patients with AP and in caerulein-stimulated AR42J cells and was associated with caspase-1 and caspase-11 activation. circHIPK3 silencing ameliorated caerulein-induced cell damage and reduced the release of inflammatory factors IL-1β, IL-6, IL-8, and TNF-α and inhibited the activation of caspase-1 and caspase-11. In addition, circHIPK3 bound to miR-193a-5p and negatively regulated its expression. Inhibition of miR-193a-5p increased the release of IL-1β, IL-6, IL-8, and TNF-α and activated caspase-1 and caspase-11, thereby counteracting the effect of circHIPK3 silencing on caerulein-induced cell damage. Furthermore, we identified GSDMD as a target gene of miR-193a-5p, which is the key gene for pyroptosis. Interfering with the expression of GSDMD can increase cell viability, reduce the secretion of inflammatory cytokines, and suppress the activation of cleaved caspase-1 and caspase-11. Silencing GSDMD reversed the effects of miR-193a-5p inhibitors on caerulein-induced damage. In conclusion, circHIPK3 promotes pyroptosis in acinar cells through regulation of the miR-193a-5p/GSDMD axis, which eventually aggravates AP disease.

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Section: Introductionmentioning

confidence: 99%

CircHIPK3 Promotes Pyroptosis in Acinar Cells Through Regulation of the miR-193a-5p/GSDMD Axis

Wang

Liu

et al. 2020

Front. Med.

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“…In addition, numerous studies have shown that EN is safe and effective in AP patients and is associated with lower mortality, organ failure, infectious complications and surgery rates [ 19 , 33 , 34 , 35 , 36 , 37 ]. PN is not sufficient in SAP patients, because can lead to the increased gut dysfunction without trophic nutrition necessary for enterocytes and gut integrity, because it has been shown that exclusive PN can lead to the intestinal atrophy [ 18 ].…”

Section: Gut Rousing But Not Resting and No “Pancreatic Rest” In Sap Patientsmentioning

confidence: 99%

“…The disease leads to undernutrition and disturbances of water/electrolyte and acid-base balance. Therefore, energy and protein requirements are higher in patients with SAP [ 17 , 18 , 19 ]. The pancreatic damage and infectious complications are associated with hyperglycemia which must be controlled, is induced by damage to beta cells, insulin resistance, and infectious complications.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, all patients with SAP are at nutritional risk and require nutritional intervention [ 17 ]. Moreover, just at the SAP beginning, damage to enterocytes due to microcirculatory injury and gut hypoperfusion leads to increased gastrointestinal permeability and translocation of systemic cytokines, toxins, and bacteria [ 18 , 20 ]. Therefore, the goal of the nutritional support (NS) in AP is not only to prevent and treat malnutrition, but also modulate and decrease altered inflammatory response [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Nutritional Support in Patients with Severe Acute Pancreatitis-Current Standards

Jabłońska

Mrowiec

2021

Nutrients

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Severe acute pancreatitis (SAP) leads to numerous inflammatory and nutritional disturbances. All SAP patients are at a high nutritional risk. It has been proven that proper nutrition significantly reduces mortality rate and the incidence of the infectious complications in SAP patients. According to the literature, early (started within 24–48 h) enteral nutrition (EN) is optimal in most patients. EN protects gut barrier function because it decreases gastrointestinal dysmotility secondary to pancreatic inflammation. Currently, the role of parenteral nutrition (PN) in SAP patients is limited to patients in whom EN is not possible or contraindicated. Early versus delayed EN, nasogastric versus nasojejunal tube for EN, EN versus PN in SAP patients and the role of immunonutrition (IN) in SAP patients are discussed in this review.

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“…More often, the current drug therapy is used to ease the symptoms, for instance, inhibiting the pancreatic enzyme secretion or mitigating the sharp pain. Once diagnosed with acute pancreatitis, fluid resuscitation, also named nutrition support, is often used to improve intestinal and pancreatic microcirculation perfusion, avoiding the ischemia-induced secondary pancreatic infection and bacterial translocation (O’Brien & Omer, 2019 ; Ramanathan & Aadam, 2019 ). Enzyme therapy that aims to restore the balance of pancreatic secretion to ease the pain was also employed in clinic for the treatment of acute pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

Drug discovery and formulation development for acute pancreatitis

et al. 2020

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Acute pancreatitis is a sudden inflammation and only last for a short time, but might lead to a life-threatening emergency. Traditional drug therapy is an essential supportive method for acute pancreatitis treatment, yet, failed to achieve satisfactory therapeutic outcomes. To date, it is still challenging to develop therapeutic medicine to redress the intricate microenvironment promptly in the inflamed pancreas, and more importantly, avoid multi-organ failure. The understanding of the acute pancreatitis, including the causes, mechanism, and severity judgment, could help the scientists bring up more effective intervention and treatment strategies. New formulation approaches have been investigated to precisely deliver therapeutics to inflammatory lesions in the pancreas, and some even could directly attenuate the pancreatic damages. In this review, we will briefly introduce the involved pathogenesis and underlying mechanisms of acute pancreatitis, as well as the traditional Chinese medicine and the new drug option. Most of all, we will summarize the drug delivery strategies to reduce inflammation and potentially prevent the further development of pancreatitis, with an emphasis on the bifunctional nanoparticles that act as both drug delivery carriers and therapeutics.

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Nutrition Management in Acute Pancreatitis

Cited by 25 publications

References 49 publications

CircHIPK3 Promotes Pyroptosis in Acinar Cells Through Regulation of the miR-193a-5p/GSDMD Axis

CircHIPK3 Promotes Pyroptosis in Acinar Cells Through Regulation of the miR-193a-5p/GSDMD Axis

Nutritional Support in Patients with Severe Acute Pancreatitis-Current Standards

Drug discovery and formulation development for acute pancreatitis

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