DiMagno Matthew J, Dimagno Eugene P
Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Curr Opin Gastroenterol. 2006 Sep;22(5):487-97. doi: 10.1097/01.mog.0000239862.96833.89.
As in our previous reviews, we endeavor to review important new observations in chronic pancreatitis made in the past year. Topics recently reviewed were truncated to accommodate a surge in publications on clinical aspects of chronic pancreatitis, which contained new observations or insights into new or old concepts.
Cystic fibrosis carriers have been found to be at increased risk of pancreatitis. Autoimmune pancreatitis may belong to a multiorgan immunoglobulin G4-related autoimmune disease, and the natural history of chronic pancreatitis differs among the etiologies. Diffusion-weighted magnetic resonance imaging improves upon previous methodologies for diagnosing reduced pancreatic exocrine secretion, and fecal elastase-1 has been found to be a poor test for diagnosing pancreatic malabsorption. Visceral hyperalgesia or heightened central pain perception may contribute to pain in chronic pancreatitis. Instruments are evolving to assess quality of life in chronic pancreatitis, and fibrolytic agents have been found to have therapeutic promise.
Researchers this past year have further characterized genetic, molecular and clinical aspects of chronic pancreatitis. Advancing the understanding of fibrogenesis, mechanisms of exocrine insufficiency, calcification, and pain and continuing development/modification of diagnostic tests should lead to improved prevention, detection and treatment of the condition. More accurate quantification of outcomes is critical for translating potential therapies from bench to bedside.
与我们之前的综述一样，我们致力于回顾过去一年中关于慢性胰腺炎的重要新观察结果。最近回顾的主题进行了精简，以适应慢性胰腺炎临床方面出版物数量的激增，这些出版物包含了对新的或旧的概念的新观察结果或见解。
已发现囊性纤维化携带者患胰腺炎的风险增加。自身免疫性胰腺炎可能属于一种多器官免疫球蛋白G4相关的自身免疫性疾病，并且慢性胰腺炎的自然病程在不同病因之间有所不同。扩散加权磁共振成像在诊断胰腺外分泌功能降低方面比以前的方法有所改进，并且已发现粪便弹性蛋白酶-1在诊断胰腺吸收不良方面是一种较差的检测方法。内脏痛觉过敏或中枢性疼痛感知增强可能导致慢性胰腺炎疼痛。评估慢性胰腺炎生活质量的工具正在不断发展，并且已发现纤溶药物具有治疗前景。
过去一年，研究人员进一步对慢性胰腺炎的遗传、分子和临床方面进行了特征描述。加深对纤维化形成、外分泌功能不全机制、钙化和疼痛的理解，以及持续开发/改进诊断测试，应会改善对该疾病的预防、检测和治疗。更准确地量化结果对于将潜在疗法从实验室转化到临床至关重要。
