Ko Juyeon, Petrov Maxim S
College of Medicine, Yonsei University, Seoul, Republic of Korea.
School of Medicine, University of Auckland, Auckland, New Zealand.
Diabetes Metab Syndr Obes. 2025 May 7;18:1489-1500. doi: 10.2147/DMSO.S400276. eCollection 2025.
The global burden of pancreatitis is substantial, bedevilled by the lack of pathogenesis-based treatments for acute pancreatitis and chronic pancreatitis. The integrated PANDORA (PANcreatic Diseases Originating from intRa-pancreatic fAt) hypothesis "moved the needle" on thinking why pancreatitis develops by bringing fat in the pancreas to the fore. A total of 20 original clinical studies exploring an uncharted territory of fat in the pancreas and pancreatitis were published between 2019 and 2024 as part of the COSMOS (Clinical and epidemiOlogical inveStigations in Metabolism, nutritiOn, and pancreatic diseaseS) program. This review concisely summarises the novel insights into the relationship of intra-pancreatic fat deposition with endocrine and exocrine pancreatic functions, behavioural and nutritional factors, as well as various biomarkers. Tapping into the wealth of knowledge derived from the COSMOS program can unlock new perspectives on the treatment of acute pancreatitis and chronic pancreatitis.
胰腺炎的全球负担相当大，由于缺乏针对急性胰腺炎和慢性胰腺炎的基于发病机制的治疗方法而备受困扰。综合性的PANDORA（源自胰腺内脂肪的胰腺疾病）假说通过将胰腺中的脂肪问题凸显出来，在思考胰腺炎发病原因方面“取得了进展”。作为COSMOS（代谢、营养和胰腺疾病的临床与流行病学研究）项目的一部分，2019年至2024年间共发表了20项原创临床研究，探索胰腺脂肪与胰腺炎这一未知领域。本综述简要总结了胰腺内脂肪沉积与胰腺内分泌和外分泌功能、行为及营养因素以及各种生物标志物之间关系的新见解。利用从COSMOS项目中获得的丰富知识，可以为急性胰腺炎和慢性胰腺炎的治疗开辟新的视角。
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