Pancreatitis can be a progressive disorder in some patients after an episode of acute pancreatitis. The progression occurs and subsets of patience after an episode of acute pancreatitis. These include patients with risk factors of alcoholism and smoking as well as genetic disorders that have been associated with pancreatitis. The progression involves a sustained fibro-inflammatory response that leads to tissue destruction resulting in both pancreatic exocrine and endocrine insufficiency. The chronic fibro-inflammatory response also significant increases the risk of pancreatic cancer. The progression is associated with significant symptoms of pain and associated deterioration of a patient’s quality of life. The mechanisms involved in the progression are under active investigation with the objective of identifying key molecular steps that can q addressed by therapeutic intervention. Key cellular participants involved include the pancreatic stellate cell and its interaction with myeloid and lymphoid cells recruited into the tissue and Transforming Growth Factor-b signaling pathways.
The goals in the field are to: 1. Develop radiologic and liquid biomarkers for early detection of pancreatitis disease progression; 2. Use methods to characterize patients by geno- pheno-type by disease stage for precision application of therapeutic applications; 3. Develop therapeutics to molecular targets specific to geno- pheno-types and disease stage; 4. Develop non-narcotic approaches to symptom improvements; 5. Develop therapeutics for prevention and treatment of diabetes due to pancreatitis; and 6. Develop approaches to prevent pancreatic cancer. The presentation will provide an examples of projects and clinical trials addressing these goals for discussion.