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Commentary 10.1172/JCI146210

Chemical pancreatectomy: an unconventional approach to preventing autodigestion in pancreatitis

Rodger A. Liddle

Department of Medicine, Duke University Medical Center, and Department of Veterans Affairs Health Care System, Durham, North Carolina, USA.

Address correspondence to: Rodger A. Liddle, Box 103859, 1033A Genome Science Research Building – 1, 905 LaSalle Street, Duke University Medical Center, Durham, North Carolina 27710, USA. Phone: 919.681.6380; Email: rodger.liddle@duke.edu.

Find articles by Liddle, R. in: JCI | PubMed | Google Scholar |

Published February 1, 2021 - More info

Published in Volume 131, Issue 3 on February 1, 2021
J Clin Invest. 2021;131(3):e146210. https://doi.org/10.1172/JCI146210.
© 2021 American Society for Clinical Investigation
Published February 1, 2021 - Version history
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Due to progressive inflammation, chronic pancreatitis destroys both the exocrine and endocrine pancreas and sensitizes pancreatic nerves, leading to unremitting pain. Unfortunately, there are no treatments for pancreatic inflammation and approaches to ameliorate pain are suboptimal. Pancreatic inflammation is particularly problematic because damage to acinar cells causes local release of digestive enzymes, which initiate pancreatic autodigestion. The combination of autodigestion and inflammation is unique to pancreatitis and undoubtedly contributes to the difficulty in devising effective treatments. In this issue of the JCI, Saleh et al. describe a nonsurgical technique to ablate pancreatic acinar cells, thus eliminating the source of digestive enzymes and preventing autodigestion. In mice and a nonhuman primate model, this approach effectively reduced inflammation and pain while preserving islet cell function. These findings support the concept that ongoing acinar cell damage is at the root of chronic pancreatitis and provide a possible strategy for clinical treatment.

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