CVB-induced pancreatitis and alterations in gene expression

While infections with the group B coxsackieviruses are generally asymptomatic, these viruses occasionally cause acute and chronic inflammatory diseases of the pancreas and heart. Chronic inflammatory diseases are of major clinical concern, since they predispose affected individuals to cancer. For example, chronic pancreatitis, which can develop from acute pancreatitis, is a major risk factor for pancreatic cancer, a disease with an exceedingly poor prognosis. It is crucial that we understand the mechanisms underlying the development of acute pancreatitis and the progression to chronic disease, if we are to identify new therapeutic targets to prevent the deterioration of the exocrine pancreas. We have developed a mouse model that allows us to explore the mechanisms by which CVB4 causes acute and chronic pancreatitis. The present review develops the idea that disease progression is a continuum, from acute inflammatory disease to chronic inflammatory disease to cancer, and that accompanying changes in gene expression are both quantitative and qualitative.