HYPERTRIGLYCERIDEMIC ACUTE PANCREATITIS: PROGRESS AND PROBLEMS

Abstract

The purpose of the review. Analyze basic data on the hypertrigliceridemia (HTG) role in the pathogenesis of HTG-associated acute pancreatitis (AP), and the current treatment of the disease. Recent literature data. HTG-associated AP met in 5-15 % of the AP cases. In the HTG-associated AP pathogenesis leading role belongs to obstruction of capillaries by TG and chylomicrons, local ischemia of the pancreas, as well as the accumulation of toxic free fatty acids by TG hydrolysis, resulting in damage to the acinary cells and capillary epithelium, which exacerbates acidosis and stimulates premature trypsinogen activation with the initiation of acute edematous or necrotizing pancreatitis. Modern treatment of HTG-associated AP include plasmapheresis to the TG levels of 300-500 mg/dL, then - diet, refuse from alcohol, drugs: omega-3 fatty acids, fibrates, nicotinic acid. Planned for lipoprotein lipase deficiency gene therapy by injecting a viral vector alipogen tiparvovek, resulting in significantly increasing of lipoprotein lipase activity, decreased plasma triglycerides and chylomicrons levels and decreases the incidence of AP.

Keywords

• acute pancreatitis
• hypertriglyceridemia
• treatment