Bockman D E, Singh M, Laugier R, Sarles H
Scand J Gastroenterol Suppl. 1985;112:106-13. doi: 10.3109/00365528509092220.
Alcohol may affect the integrity of the pancreatic parenchyma, as seen in alcoholic pancreatitis, some cases of chronic alcoholism without clinical pancreatitis, and experimental studies. The composition of pancreatic juice may reflect some of these changes. One type of parenchymal alteration is the loss of differentiative features of acinar cells, so that they take on the characteristics of ductular cells. Concomitant fibrosis completes the formation of the tubular complexes found in association with alcoholic chronic pancreatitis. Sustained alcohol intake may produce the accumulation of lipid droplets in parenchymal cells, some of which may be shown to be within the rough endoplasmic reticulum of acinar cells. Epithelial cells may undergo mucous metaplasia. The epithelial-basal lamina barrier frequently is breached in the area of intraluminal aggregates, with or without obvious inflammation in the immediate area. Loss of barrier function may lead to interaction among components of the external compartment (lumen) and the internal compartment (stroma). Increased levels of blood proteins and glycosaminoglycans in the juice, enzyme activation, fibrin formation, and complement activation are potential consequences of barrier loss. Increased lactoferrin levels could result in part from the activity and degranulation of polymorphonuclear leukocytes.
酒精可能会影响胰腺实质的完整性，如在酒精性胰腺炎、一些无临床胰腺炎的慢性酒精中毒病例以及实验研究中所见。胰液的成分可能反映其中一些变化。一种实质改变是腺泡细胞丧失分化特征，从而呈现导管细胞的特性。伴随的纤维化完成了与酒精性慢性胰腺炎相关的管状复合体的形成。持续摄入酒精可能会导致实质细胞内脂滴积聚，其中一些脂滴可能存在于腺泡细胞的粗面内质网内。上皮细胞可能会发生黏液化生。在管腔内聚集体区域，上皮-基膜屏障常常被破坏，紧邻区域有无明显炎症均可如此。屏障功能丧失可能导致外部腔隙（管腔）和内部腔隙（基质）的成分之间相互作用。胰液中血液蛋白质和糖胺聚糖水平升高、酶激活、纤维蛋白形成以及补体激活都是屏障丧失的潜在后果。乳铁蛋白水平升高可能部分源于多形核白细胞的活性和脱颗粒。
