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Review
. 2023 Sep 6;26(4):495.
doi: 10.3892/etm.2023.12194. eCollection 2023 Oct.

Clinical treatment for persistent inflammation, immunosuppression and catabolism syndrome in patients with severe acute pancreatitis (Review)

Bo Zhang  1 , Qigui Xiao  1 , Qingyong Ma  1 , Liang Han  1
Affiliations
Review

Clinical treatment for persistent inflammation, immunosuppression and catabolism syndrome in patients with severe acute pancreatitis (Review)

Bo Zhang et al. Exp Ther Med. .

Abstract

Severe acute pancreatitis (SAP) is a severe disease with a high prevalence and a 3-15% mortality worldwide, and premature activation of zymogen for any reason is the initial factor for the onset of SAP. Gallstone disease and heavy alcohol consumption are the two most common etiologies of SAP. Persistent inflammation, immunosuppression and catabolism syndrome (PICS) is a life-threatening illness, and there are no effective treatments. The relapse state of PICS mainly leads to high mortality due to septic shock or severe trauma, both of which are dangerous and challenging conditions for clinicians. Thus, it is important for medical staff to identify patients at high risk of PICS and to master the prevention and treatment of PICS in patients with SAP. The present review aims to increase the understanding of the pathogenesis of PICS, produce evidence for PICS diagnosis and highlight clinical treatment for PICS in patients with SAP. With this information, clinical workers could implement standardized and integrated measures at an early stage of SAP to stop its progression to PICS.

Keywords: SAP; catabolic syndrome; clinical treatment; immunosuppression; persistent inflammation.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Evolution of persistent inflammation, immunosuppression and catabolism syndrome in severe acute pancreatitis. CARS, compensatory anti-inflammatory response syndrome; ICU, intensive care unit; MARS, mixed antagonistic response syndrome; MOF, multiorgan failure; SIRS, systemic inflammatory response syndrome.
Figure 2
Figure 2
Interventions for persistent inflammation, immunosuppression and catabolism syndrome. EN, enteral nutrition; GM-CSF, granulocyte-macrophage colony stimulating factor.
See this image and copyright information in PMC

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References

    1. Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS. Classification of acute pancreatitis-2012: Revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–111. doi: 10.1136/gutjnl-2012-302779. Acute Pancreatitis Classification Working Group. - DOI - PubMed
    1. Wilkman E, Kaukonen KM, Pettila V, Kuitunen A, Varpula M. Early hemodynamic variables and outcome in severe acute pancreatitis: A retrospective single-center cohort study. Pancreas. 2013;42:272–278. doi: 10.1097/MPA.0b013e318264c9f7. - DOI - PubMed
    1. Hawkins RB, Raymond SL, Stortz JA, Horiguchi H, Brakenridge SC, Gardner A, Efron PA, Bihorac A, Segal M, Moore FA, Moldawer LL. Chronic critical Illness and the persistent inflammation, immunosuppression, and catabolism Syndrome. Front Immunol. 2018;9(1511) doi: 10.3389/fimmu.2018.01511. - DOI - PMC - PubMed
    1. Rosenthal MD, Moore FA. Persistent inflammation, immunosuppression, and catabolism: Evolution of multiple organ dysfunction. Surg Infect (Larchmt) 2016;17:167–172. doi: 10.1089/sur.2015.184. - DOI - PMC - PubMed
    1. Osuchowski MF, Craciun F, Weixelbaumer KM, Duffy ER, Remick DG. Sepsis Chronically in MARS: Systemic cytokine responses are always mixed regardless of the outcome, magnitude, or phase of sepsis. J Immunol. 2012;189:4648–4656. doi: 10.4049/jimmunol.1201806. - DOI - PMC - PubMed

Grants and funding

Funding: The present study was supported by the National Natural Science Foundation of China (grant no. 82072699).