Liddle Rodger A
Department of Medicine, Box 3913, Duke University and Durham VA Medical Center, Durham, NC 27710, USA.
Biochim Biophys Acta. 2007 Aug;1772(8):869-78. doi: 10.1016/j.bbadis.2007.02.012. Epub 2007 Mar 12.
Premature activation of digestive enzymes within the pancreas which leads to autodigestion of the gland is an early step in the pathogenesis of pancreatitis. Pancreatic injury is followed by other manifestations of inflammation including plasma extravasation, edema, and neutrophil infiltration which constitute the features of pancreatitis. Recent studies indicate that neural innervation of the pancreas may play an important role in the initiation and maintenance of the inflammatory response to injury. The pancreas is innervated by vagal, sympathetic and parasympathetic neurons, as well as sensory neurons. Activation of pancreatic primary sensory neurons causes the release of inflammatory neuropeptides both in the spinal cord to signal pain and in the pancreas itself where they produce plasma extravasation and neutrophil infiltration. Recent studies indicate that primary sensory neurons of the pancreas express transient receptor potential V1 (TRPV1) channels whose activation induces pancreatic inflammation. Moreover, blockade of these TRP channels significantly ameliorates experimental pancreatitis. This review describes our current understanding of the role of TRPV1 channels in pancreatitis and illustrates how this mechanism might be used to direct future treatments of pancreatic diseases.
胰腺内消化酶的过早激活会导致胰腺自身消化，这是胰腺炎发病机制的早期步骤。胰腺损伤之后会出现其他炎症表现，包括血浆外渗、水肿和中性粒细胞浸润，这些构成了胰腺炎的特征。最近的研究表明，胰腺的神经支配可能在对损伤的炎症反应的启动和维持中起重要作用。胰腺由迷走神经、交感神经和副交感神经神经元以及感觉神经元支配。胰腺初级感觉神经元的激活会导致炎症性神经肽在脊髓中释放以传递疼痛信号，同时也会在胰腺自身释放，在胰腺中它们会引起血浆外渗和中性粒细胞浸润。最近的研究表明，胰腺的初级感觉神经元表达瞬时受体电位香草酸亚型1（TRPV1）通道，其激活会诱发胰腺炎症。此外，阻断这些TRP通道可显著改善实验性胰腺炎。这篇综述描述了我们目前对TRPV1通道在胰腺炎中作用的理解，并说明了该机制如何可能用于指导未来胰腺疾病的治疗。
