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World J Gastroenterol. Nov 7, 2014; 20(41): 15190-15199
Published online Nov 7, 2014. doi: 10.3748/wjg.v20.i41.15190
Role of phosphoinositide 3-kinase in the pathogenesis of acute pancreatitis
Enrico Lupia, Luca Pigozzi, Alberto Goffi, Emilio Hirsch, Giuseppe Montrucchio
Enrico Lupia, Luca Pigozzi, Giuseppe Montrucchio, Department of Medical Sciences, University of Torino, 10126 Torino, Italy
Enrico Lupia, Luca Pigozzi, Emergency Medicine Unit, “Città della Salute e della Scienza” Hospital, 10126 Torino, Italy
Alberto Goffi, Interdepartmental Division of Critical Care Medicine, University of Toronto, Ontario ON M5G 1X5, Canada
Emilio Hirsch, Molecular Biotechnology Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, 10126 Torino, Italy
Author contributions: Lupia E, Pigozzi L, Goffi A, Hirsch E and Montrucchio G reviewed the literature and structured the manuscript content; Lupia E, Pigozzi L and Hirsch E wrote the manuscript.
Supported by Ministero dell’Università e della Ricerca Scientifica e Tecnologica (MURST, ex-60% to GM and EL)
Correspondence to: Enrico Lupia, MD, Department of Medical Sciences, University of Torino, Via Genova 3, 10126 Torino, Italy. enrico.lupia@unito.it
Telephone: +39-11-6705395 Fax: +39-11-6705367
Received: March 1, 2014
Revised: June 12, 2014
Accepted: July 22, 2014
Published online: November 7, 2014
Abstract

A large body of experimental and clinical data supports the notion that inflammation in acute pancreatitis has a crucial role in the pathogenesis of local and systemic damage and is a major determinant of clinical severity. Thus, research has recently focused on molecules that can regulate the inflammatory processes, such as phosphoinositide 3-kinases (PI3Ks), a family of lipid and protein kinases involved in intracellular signal transduction. Studies using genetic ablation or pharmacologic inhibitors of different PI3K isoforms, in particular the class I PI3Kδ and PI3Kγ, have contributed to a greater understanding of the roles of these kinases in the modulation of inflammatory and immune responses. Recent data suggest that PI3Ks are also involved in the pathogenesis of acute pancreatitis. Activation of the PI3K signaling pathway, and in particular of the class IB PI3Kγ isoform, has a significant role in those events which are necessary for the initiation of acute pancreatic injury, namely calcium signaling alteration, trypsinogen activation, and nuclear factor-κB transcription. Moreover, PI3Kγ is instrumental in modulating acinar cell apoptosis, and regulating local neutrophil infiltration and systemic inflammatory responses during the course of experimental acute pancreatitis. The availability of PI3K inhibitors selective for specific isoforms may provide new valuable therapeutic strategies to improve the clinical course of this disease. This article presents a brief summary of PI3K structure and function, and highlights recent advances that implicate PI3Ks in the pathogenesis of acute pancreatitis.

Keywords: Phosphoinositide 3-kinase, Cell signaling, Inflammation, Pathogenesis, Acute pancreatitis

Core tip: Phosphoinositide 3-kinases (PI3Ks) are a family of lipid and protein kinases implicated in intracellular signal transduction and regulation of inflammation. Recent data suggest their involvement also in the pathogenesis of acute pancreatitis. PI3Ks, and in particular the PI3Kγ isoform, have a significant role in those events which are necessary for the initiation of acute pancreatic injury, namely calcium signaling alteration, trypsinogen activation, and nuclear factor-κB transcription. Moreover, PI3Kγ modulates acinar cell apoptosis, and regulates local and systemic inflammatory responses during experimental acute pancreatitis. Specific PI3K inhibitors may therefore provide new therapies to improve the clinical course of this disease.