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大麻在急性胰腺炎病因学中未被充分认识的作用。

The Underrecognized Role of Cannabis in the Etiology of Acute Pancreatitis.

作者信息

Tanvir Fnu, Singh Sumerjit, Singh Kanwarmandeep, Onwuzo Chidera N, Singh Jaskaran, Antaal Harman, Sandhu Ajay Pal Singh, Kaur Meet Sirjana, Singh Harmanjot, Singh Agamjit

机构信息

Internal Medicine, Government Medical College Amritsar, Amritsar, IND.

Diagnostic Radiology, Government Medical College Amritsar, Amritsar, IND.

出版信息

Cureus. 2024 Sep 4;16(9):e68612. doi: 10.7759/cureus.68612. eCollection 2024 Sep.

Abstract

Cannabis-induced pancreatitis (CIP) is an emerging clinical entity that presents unique challenges in diagnosis and management. This narrative review explores the current understanding of CIP, synthesizing evidence from epidemiological, pathophysiological, and clinical studies. The rising prevalence of cannabis use worldwide has been paralleled by an increase in reported cases of CIP, particularly among younger populations. Pathophysiological mechanisms involve the interaction of exogenous cannabinoids with pancreatic cannabinoid receptors, potentially disrupting normal pancreatic function and triggering inflammation. Clinical presentation of CIP often mimics other forms of acute pancreatitis (AP), necessitating a high index of suspicion and thorough history-taking for accurate diagnosis. Management strategies align with established protocols for AP, with an emphasis on supportive care and cannabis cessation to prevent recurrence. While short-term outcomes are generally favorable, the risk of progression to chronic pancreatitis in cases of continued cannabis use underscores the importance of long-term follow-up and abstinence counseling. This review also highlights significant knowledge gaps, including the need for standardized diagnostic criteria, a better understanding of dose-response relationships, and potential interactions with other risk factors. Future research directions should focus on elucidating precise pathophysiological mechanisms, developing targeted therapies, and investigating the impact of different cannabis formulations and consumption methods on pancreatic health. As cannabis use continues to increase globally, a comprehensive understanding of its effects on pancreatic function is crucial for improving patient outcomes and informing public health policies.

摘要

大麻所致胰腺炎(CIP)是一种新出现的临床病症,在诊断和管理方面存在独特挑战。本叙述性综述探讨了目前对CIP的认识,综合了来自流行病学、病理生理学和临床研究的证据。全球大麻使用的流行率不断上升,与此同时,CIP报告病例数也在增加,尤其是在年轻人群中。病理生理机制涉及外源性大麻素与胰腺大麻素受体的相互作用,可能会破坏正常的胰腺功能并引发炎症。CIP的临床表现通常与其他形式的急性胰腺炎(AP)相似,因此需要高度怀疑并详细询问病史以进行准确诊断。管理策略与既定的AP治疗方案一致,重点是支持性治疗和停止使用大麻以防止复发。虽然短期预后通常良好,但持续使用大麻的情况下进展为慢性胰腺炎的风险凸显了长期随访和戒酒咨询的重要性。本综述还强调了重大的知识空白,包括需要标准化诊断标准、更好地理解剂量反应关系以及与其他危险因素的潜在相互作用。未来的研究方向应集中在阐明精确的病理生理机制、开发靶向治疗方法以及研究不同大麻制剂和消费方式对胰腺健康的影响。随着全球大麻使用的持续增加,全面了解其对胰腺功能的影响对于改善患者预后和为公共卫生政策提供信息至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/be7e/11450675/45f0184f1b53/cureus-0016-00000068612-i01.jpg

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