Mihoc Tudorel, Latcu Silviu Constantin, Secasan Cosmin-Ciprian, Dema Vlad, Cumpanas Alin Adrian, Selaru Mircea, Pirvu Catalin Alexandru, Valceanu Andrei Paul, Zara Flavia, Dumitru Cristina-Stefania, Novacescu Dorin, Pantea Stelian
Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania.
Department X, General Surgery II, Discipline of Surgical Emergencies, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania.
Biomedicines. 2024 Nov 17;12(11):2627. doi: 10.3390/biomedicines12112627.
Acute pancreatitis is a complex inflammatory disorder with significant morbidity and mortality. This review aims to integrate the current knowledge of pancreatic morphology and immunology with the pathogenesis of acute pancreatitis, providing a comprehensive understanding of this critical condition. We conducted an extensive literature review, synthesizing data from recent studies and authoritative sources on pancreatic anatomy, histology, immunology, and the pathophysiology of acute pancreatitis. We also incorporated epidemiological data, clinical features, diagnostic criteria, and prognostic factors. The pancreas exhibits a complex morphology with intricate interactions between its exocrine and endocrine components. Its unique immunological landscape plays a crucial role in maintaining homeostasis and orchestrating responses to pathological conditions. In acute pancreatitis, the disruption of intracellular calcium signaling leads to premature enzyme activation, triggering a cascade of events including mitochondrial dysfunction, ATP depletion, and the release of proinflammatory mediators. This process can escalate from localized inflammation to systemic complications. The interplay between pancreatic morphology, immune responses, and pathophysiological mechanisms contributes to the varied clinical presentations and outcomes observed in acute pancreatitis. Understanding the intricate relationships between pancreatic morphology, immunology, and the pathogenesis of acute pancreatitis is crucial for developing more effective diagnostic and therapeutic strategies. This integrated approach provides new insights into the complex nature of acute pancreatitis and may guide future research directions in pancreatic disorders.
急性胰腺炎是一种具有显著发病率和死亡率的复杂炎症性疾病。本综述旨在将当前关于胰腺形态学和免疫学的知识与急性胰腺炎的发病机制相结合，从而全面了解这一危急病症。我们进行了广泛的文献综述，综合了近期研究以及胰腺解剖学、组织学、免疫学和急性胰腺炎病理生理学方面权威资料的数据。我们还纳入了流行病学数据、临床特征、诊断标准和预后因素。胰腺呈现出复杂的形态，其外分泌和内分泌成分之间存在着错综复杂的相互作用。其独特的免疫格局在维持体内平衡以及协调对病理状况的反应中起着关键作用。在急性胰腺炎中，细胞内钙信号的破坏导致酶过早激活，引发一系列事件，包括线粒体功能障碍、ATP耗竭以及促炎介质的释放。这一过程可从局部炎症发展为全身并发症。胰腺形态、免疫反应和病理生理机制之间的相互作用导致了急性胰腺炎中观察到的各种临床表现和结局。了解胰腺形态学、免疫学与急性胰腺炎发病机制之间的复杂关系对于制定更有效的诊断和治疗策略至关重要。这种综合方法为急性胰腺炎的复杂本质提供了新的见解，并可能指导胰腺疾病未来的研究方向。
