The role of neuromediators and cytokines in pathogenesis of chronic pancreatitis of alcohol etiology

Abstract

Aim. To determine the role of acetylcholine (AC), serotonine (5-HT) and cytokines in progression and complications of chronic alcohol pancreatitis (CAP). Material and methods. 50 CAP patients were examined in the exacerbation, remission and complications of CAP (48 males, 2 females) aged 30-50 years. Control group consisted of 15 healthy subjects. IL-lbeta, IL-6, IL-8, IFN-gamma, TNF-alpha, IL-4 were studied with enzyme immunoassay, 5-HT - with Ch. Sadovanquivad method, AC and activity of cholinesterase (CE) in the blood - by the method of Sh. Hestrin. Pancreatic tissue fibrosis was assessed according to computer tomography findings. Results. Patients with CAP in exacerbation had significant rise of proinflammatory, anti-inflammatory cytokines, AC and 5-HT. In a complicated course of CAP there is a pronounced rise in TNFa in normal level of IL-4. CAP patients with destructive changes in the pancreas showed significant rise in the level of AC and 5-HT and lowering of cytokines. CE activity in complicated course of CAP is low this indicating protein-synthetic insufficiency in CAP patients. Conclusion. In CAP the action of 5-HT and AC aims at maintenance of secretory activity of the pancreas. In inflammation participation of neuromediators decreases. Stimulation of pancreatic secretory activity switched to autonomic regulation which is prognostically unfavourable.

Keywords

• chronic pancreatitis
• cytokines
• acetylcholin
• serotonin
• cholinesteras