Molecular-genetic bases of development of acute pancreatitis

Abstract

Acute pancreatitis is included into the three most common diseases of organs of the abdominal cavity following acute appendicitis and cholecystitis, with the middle share in this group of 10-16%. As before, acute pancreatitis is characterized by high morbidity and mortality. Many researchers confirm growth of severe forms of the disease with destructive changes in the pancreas. Aim. A review of literature sources devoted to study of etiology, pathogenesis, classification, diagnosis and molecular-genetic bases of acute pancreatitis. Factors that play a role in development of the disease (episodes of infringement of the diet, cholelithiasis, vascular diseases, abuse of alcohol) are elucidated. Mechanisms of development of acute pancreatitis depending on the etiology, are described in detail, modern classification of acute pancreatitis is given. The main methods of diagnosis of the disease including both laboratory and instrumental ones, are described. Data of the methods of determination of severity of patients state based on evaluation of all the most important physiological systems, are presented. In terms of modern understanding of mechanisms of development of acute pancreatitis, the results of investigation of the probability for genetic predisposition to the studied disease are given that opens the ways for optimization of therapy and diagnosis. The results of both individual and large-scale genetic studies of acute pancreatitis are described. Research works with isolation of certain candidate genes whose protein products participate in the pathogenesis of acute pancreatitis, are presented. Conclusion. A complex approach to diagnosis of acute pancreatitis with identification of different mutations in the studied genes, and also determination of the influence of epigenetic phenomena in the individuals of risk groups will permit to improve the results of the prophylactic, diagnostic and therapeutic activity in acute pancreatitis.