Immunomodulatory therapies for acute pancreatitis

来源 :World Journal of Gastroenterology | 被引量 : 0次 | 上传用户:ytw2001
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It is currently difficult for conventional treatments of acute pancreatitis(AP),which primarily consist of antiinflammatory therapies,to prevent the progression of AP or to improve its outcome.This may be because the occurrence and progression of AP,which involves various inflammatory cells and cytokines,includes a series of complex immune events.Considering the complex immune system alterations during the course of AP,it is necessary to monitor the indicators related to immune cells and inflammatory mediators and to develop more individualized interventions for AP patients using immunomodulatory therapy.This review discusses the recent advances in immunomodulatory therapies.It has been suggested that overactive inflammatory responses should be inhibited and excessive immunosuppression should be avoided in the early stages of AP.The optimal duration of anti-inflammatory therapy may be shorter than previously expected(<24 h),and appropriate immunostimulatory therapies should be administered during the period from the 3rd d to the 14th d in the courseof AP.A combination therapy of anti-inflammatory and immune-stimulating drugs would hopefully constitute an alternative to anti-inflammatory drug monotherapy.Additionally,the detection of the genotypes of critical inflammatory mediators may be useful for screening populations of AP patients at high risk of severe infections to enable the administration of early interventions to improve their prognosis. It is currently difficult for conventional treatments of acute pancreatitis (AP), which includes consist of antiinflammatory therapies, to prevent the progression of AP or to improve its outcome. This may be because the occurrence and progression of AP, which involves various inflammatory cells and cytokines, includes a series of complex immune events. C on conring the complex immune system alterations during the course of AP, it is necessary to monitor the indicators related to immune cells and inflammatory mediators and to develop more individualized interventions for AP patients using immunomodulatory therapy. review discusses the recent advances in immunomodulatory therapies. It has been suggested that overactive inflammatory responses should be inhibited and excessive immunosuppression should be avoided in the early stages of AP. The optimal duration of anti-inflammatory therapy may be shorter than previously expected (<24 h), and appropriate immunostimulatory therapies should be administ ered during the period from the 3rd d to the 14th d in the course of AP. A combination therapy of anti-inflammatory and immune-stimulating drugs would hopefully constitute an alternative to anti-inflammatory drug monotherapy. Additionally, the detection of the genotypes of critical inflammatory mediators may be useful for screening populations of AP patients at high risk of severe infections to enable the administration of early interventions to improve their prognosis.
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