Prospective evaluation of the aetiological profile of acute pancreatitis in young adult patients

It is suspected that microbial infections take part in the pathogenesis of diabetes mellitus type 1 (T1DM). Glucose-induced insulin secretion is accompanied by the release of free arachidonic acid (AA) mainly by cytosolic- and calcium independent phospholipases A2 (cPLA2 and iPLA2). Insulinoma cell line (INS-1E) was infected with E. coli isolated from the blood culture of a patient with sepsis. Invasion assay, Scanning Electron Microscopy and Transmission Electron Microscopy demonstrated the capacity of E. coli to enter cells, which was reduced by PLA2 inhibitors. Glucose-induced insulin secretion was significantly increased after acute infection (8h) but significantly decreased after chronic infection (72h). PLA2 activities, cPLA2, iPLA2, phospho-cPLA2, and COX-2 expressions were increased after acute and, even more, after chronic E. coli infection. The silencing of the two isoforms of PLA2s, with specific cPLA2- or iPLA2-siRNAs, reduced insulin secretion after acute infection and determined a rise in insulin release after chronic infection. Prostaglandins E2 (PGE2) production was significantly elevated in INS-1E after long-term E. coli infection and the restored insulin secretion in presence of L798106, a specific EP3 antagonist, and NS-398, a COX-2 inhibitor, and the reduction of insulin secretion in presence of sulprostone, a specific EP3 agonist, revealed their involvement in the effects triggered by bacterial infection. The results obtained demonstrated that cPLA2 and iPLA2 play a key role in insulin secretion process after E. coli infection. The high concentration of AA released is transformed into PGE2, which could be responsible for the reduced insulin secretion.

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“…Apart from cigarette smoking and alcohol consumption, the remaining cases of chronic pancreatitis are considered idiopathic in nature [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Cytosolic and Calcium-Independent Phospholipases A2 Activation and Prostaglandins E2 Are Associated with Escherichia coli-Induced Reduction of Insulin Secretion in INS-1E Cells

et al. 2016

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“…6,7 The only documented prospective study analyzing cannabis use and AP development found that cannabis accounted for the etiology of 13% of all cases of AP in patients younger than the age of 35 years. 8 Furthermore, a systematic review by Sagaram et al found that males had a higher proportion of cannabis-induced pancreatitis compared with females. 9 It also documented that there was an increase in the proportion of males and the proportion of patients younger than the age of 35 years with more severe cases of pancreatitis.…”

Section: Discussionmentioning

confidence: 99%

Cannabis-Induced Pancreatitis in a Young Adult Male

Sly

Clark

Karaghossian

et al. 2021

Journal of Investigative Medicine High Impact Case Reports

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Drugs account for 2% of all the causes of acute pancreatitis. To date, there are approximately 26 reported cases of acute pancreatitis associated with the use of cannabis. We report the case of a 20-year-old male who presented with intractable nausea, vomiting, and epigastric pain and a lipase level of 1541 with reportedly no alcohol use, and no evidence of medication, biliary, or autoimmune etiology. However, the patient did endorse heavily smoking cannabis prior to symptom onset. He was instructed to abstain from cannabis use on discharge and has not presented to the hospital since this episode. The reporting of this case aims to increase awareness of cannabis as a differential diagnosis in cases of pancreatitis that is not due to typical etiologies such as gallstones, medications, and alcohol use. There has yet to be definitive evidence as to how cannabis can cause pancreatitis. Further studies must be conducted to better understand the association between cannabis use and acute pancreatitis and the mechanism by which cannabis affects the pancreas.

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“…Cases of cannabis-related acute pancreatitis have also been described. 6 Potential mechanisms may involve inhibition of sensory nerves and increased proinflammatory mediator infiltration. 7 Furthermore, cannabinoid receptors (CB1 and CB2) are found in pancreatic tissue.…”

Section: Case Descriptionmentioning

confidence: 99%

Cannabinoid Disposition After Human Intraperitoneal Use: An Insight Into Intraperitoneal Pharmacokinetic Properties in Metastatic Cancer

Lucas

Galettis

Song

et al. 2018

Clinical Therapeutics

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Prospective evaluation of the aetiological profile of acute pancreatitis in young adult patients

Cited by 24 publications

References 35 publications

Cytosolic and Calcium-Independent Phospholipases A2 Activation and Prostaglandins E2 Are Associated with Escherichia coli-Induced Reduction of Insulin Secretion in INS-1E Cells

Cytosolic and Calcium-Independent Phospholipases A2 Activation and Prostaglandins E2 Are Associated with Escherichia coli-Induced Reduction of Insulin Secretion in INS-1E Cells

Cannabis-Induced Pancreatitis in a Young Adult Male

Cannabinoid Disposition After Human Intraperitoneal Use: An Insight Into Intraperitoneal Pharmacokinetic Properties in Metastatic Cancer

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