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World J Gastroenterol. Dec 7, 2014; 20(45): 16868-16880
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.16868
Pharmacologic therapy for acute pancreatitis
Swetha Kambhampati, Walter Park, Aida Habtezion
Swetha Kambhampati, Walter Park, Aida Habtezion, Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States
Author contributions: All the authors contributed to this manuscript.
Supported by Robert Wood Johnson Foundation grant (to Habtezion A); National Institutes of Health Grant DK092421 (to Habtezion A); and American College of Gastroenterology (to Park W)
Correspondence to: Dr. Aida Habtezion, MD, Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, United States. aidah@stanford.edu
Telephone: +1-650-7253362 Fax: +1-650-7235488
Received: May 22, 2014
Revised: July 23, 2014
Accepted: October 15, 2014
Published online: December 7, 2014
Processing time: 202 Days and 15.1 Hours
Abstract

While conservative management such as fluid, bowel rest, and antibiotics is the mainstay of current acute pancreatitis management, there is a lot of promise in pharmacologic therapies that target various aspects of the pathogenesis of pancreatitis. Extensive review of preclinical studies, which include assessment of therapies such as anti-secretory agents, protease inhibitors, anti-inflammatory agents, and anti-oxidants are discussed. Many of these studies have shown therapeutic benefit and improved survival in experimental models. Based on available preclinical studies, we discuss potential novel targeted pharmacologic approaches that may offer promise in the treatment of acute pancreatitis. To date a variety of clinical studies have assessed the translational potential of animal model effective experimental therapies and have shown either failure or mixed results in human studies. Despite these discouraging clinical studies, there is a great clinical need and there exist several preclinical effective therapies that await investigation in patients. Better understanding of acute pancreatitis pathophysiology and lessons learned from past clinical studies are likely to offer a great foundation upon which to expand future therapies in acute pancreatitis.

Keywords: Acute pancreatitis; Antisecretory; Protease inhibitors; Anti-inflammatory; Anti-oxidants; Systemic inflammatory response syndrome; Organ failure; Mortality

Core tip: Currently there are no approved therapies for acute pancreatitis. This review summarizes and discusses pre-clinical and clinical studies in acute pancreatitis and also discusses potential promising therapies.