Scientific Reports (Jan 2021)
Evidence for diagnosis of early chronic pancreatitis after three episodes of acute pancreatitis: a cross-sectional multicentre international study with experimental animal model
- Péter J. Hegyi,
- Alexandra Soós,
- Emese Tóth,
- Attila Ébert,
- Viktória Venglovecz,
- Katalin Márta,
- Péter Mátrai,
- Alexandra Mikó,
- Judit Bajor,
- Patrícia Sarlós,
- Áron Vincze,
- Adrienn Halász,
- Ferenc Izbéki,
- Zoltán Szepes,
- László Czakó,
- György Kovács,
- Mária Papp,
- Zsolt Dubravcsik,
- Márta Varga,
- József Hamvas,
- Balázs C. Németh,
- Melania Macarie,
- Ali Tüzün Ince,
- Dmitry S. Bordin,
- Elena A. Dubtsova,
- Mariya A. Kiryukova,
- Igor E. Khatkov,
- Tanya Bideeva,
- Artautas Mickevicius,
- Elena Ramírez-Maldonado,
- Ville Sallinen,
- Bálint Erőss,
- Dániel Pécsi,
- Andrea Szentesi,
- Andrea Párniczky,
- László Tiszlavicz,
- Péter Hegyi
Affiliations
- Péter J. Hegyi
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs
- Alexandra Soós
- Department of Medicine, University of Szeged
- Emese Tóth
- Department of Medicine, University of Szeged
- Attila Ébert
- Department of Pharmacology and Pharmacotherapy
- Viktória Venglovecz
- Department of Pharmacology and Pharmacotherapy
- Katalin Márta
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs
- Péter Mátrai
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs
- Alexandra Mikó
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs
- Judit Bajor
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs
- Patrícia Sarlós
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs
- Áron Vincze
- Division of Gastroenterology, First Department of Medicine, Medical School, University of Pécs
- Adrienn Halász
- Szent György Teaching Hospital of County Fejér
- Ferenc Izbéki
- Szent György Teaching Hospital of County Fejér
- Zoltán Szepes
- Department of Medicine, University of Szeged
- László Czakó
- Department of Medicine, University of Szeged
- György Kovács
- Department of Internal Medicine, Division of Gastroenterology, University of Debrecen
- Mária Papp
- Department of Internal Medicine, Division of Gastroenterology, University of Debrecen
- Zsolt Dubravcsik
- Bács-Kiskun County Hospital
- Márta Varga
- Dr. Réthy Pál Hospital
- József Hamvas
- Peterfy Hospital and Trauma, Trauma Emergency Room
- Balázs C. Németh
- Department of Medicine, University of Szeged
- Melania Macarie
- County Emergency Clinical Hospital - Gastroenterology and, University of Medicine, Pharmacy, Sciences and Technology
- Ali Tüzün Ince
- School of Medicine, Hospital of Bezmialem Vakif University
- Dmitry S. Bordin
- A.S. Loginov Moscow Clinical Scientific Center
- Elena A. Dubtsova
- A.S. Loginov Moscow Clinical Scientific Center
- Mariya A. Kiryukova
- A.S. Loginov Moscow Clinical Scientific Center
- Igor E. Khatkov
- A.S. Loginov Moscow Clinical Scientific Center
- Tanya Bideeva
- Semashko Central Clinical Hospital
- Artautas Mickevicius
- Clinic of Gastroenterology, Nephrourology and Abdominal Surgery, Faculty of Medicine, Vilnius University
- Elena Ramírez-Maldonado
- Consorci Sanitari del Garraf, Sant Pere de Ribes
- Ville Sallinen
- Department of Abdominal Surgery, University of Helsinki and Helsinki University Hospital
- Bálint Erőss
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs
- Dániel Pécsi
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs
- Andrea Szentesi
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs
- Andrea Párniczky
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs
- László Tiszlavicz
- Department of Pathology, University of Szeged
- Péter Hegyi
- Institute for Translational Medicine, Medical School, Szentágothai Research Centre, University of Pécs
- DOI
- https://doi.org/10.1038/s41598-020-80532-6
- Journal volume & issue
-
Vol. 11,
no. 1
pp. 1 – 14
Abstract
Abstract Chronic pancreatitis (CP) is an end-stage disease with no specific therapy; therefore, an early diagnosis is of crucial importance. In this study, data from 1315 and 318 patients were analysed from acute pancreatitis (AP) and CP registries, respectively. The population from the AP registry was divided into AP (n = 983), recurrent AP (RAP, n = 270) and CP (n = 62) groups. The prevalence of CP in combination with AP, RAP2, RAP3, RAP4 and RAP5 + was 0%, 1%, 16%, 50% and 47%, respectively, suggesting that three or more episodes of AP is a strong risk factor for CP. Laboratory, imaging and clinical biomarkers highlighted that patients with RAP3 + do not show a significant difference between RAPs and CP. Data from CP registries showed 98% of patients had at least one AP and the average number of episodes was four. We mimicked the human RAPs in a mouse model and found that three or more episodes of AP cause early chronic-like morphological changes in the pancreas. We concluded that three or more attacks of AP with no morphological changes to the pancreas could be considered as early CP (ECP).The new diagnostic criteria for ECP allow the majority of CP patients to be diagnosed earlier. They can be used in hospitals with no additional costs in healthcare.
