[The role of neuromediators and cytokines in pathogenesis of chronic pancreatitis of alcohol etiology].

AIM

To determine the role of acetylcholine (AC), serotonine (5-HT) and cytokines in progression and complications of chronic alcohol pancreatitis (CAP).

MATERIAL AND METHODS

50 CAP patients were examined in the exacerbation, remission and complications of CAP (48 males, 2 females) aged 30-50 years. Control group consisted of 15 healthy subjects. IL-1beta, IL-6, IL-8, IFN-gamma, TNF-alpha, IL-4 were studied with enzyme immunoassay, 5-HT--with Ch. Sadovanquivad method, AC and activity of cholinesterase (CE) in the blood--by the method of Sh. Hestrin. Pancreatic tissue fibrosis was assessed according to computer tomography findings.

RESULTS

Patients with CAP in exacerbation had significant rise of proinflammatory, anti-inflammatory cytokines, AC and 5-HT. In a complicated course of CAP there is a pronounced rise in TNFalpha in normal level of IL-4. CAP patients with destructive changes in the pancreas showed significant rise in the level of AC and 5-HT and lowering of cytokines. CE activity in complicated course of CAP is low this indicating protein-synthetic insufficiency in CAP patients.

CONCLUSION

In CAP the action of 5-HT and AC aims at maintenance of secretory activity of the pancreas. In inflammation participation of neuromediators decreases. Stimulation of pancreatic secretory activity switched to autonomic regulation which is prognostically unfavourable.