Role of oxidative stress in the pathogenesis of acute pancreatitis

During the last 10 years, the role of oxidative stress in pancreatitis and the benefits or otherwise of antioxidants has been the subject of numerous research papers. There is general agreement that glutathione and other sulphydryl compounds are depleted while lipid peroxidation is increased in pancreatic tissue during the development of acute pancreatitis. Treatment with antioxidants has been shown to reduce acinar cell injury and oedema in various animal models of pancreatitis, suggesting that the sustained generation of reactive oxygen species depletes cellular antioxidant defences. Evidence for a role for bradykinin and nitric oxide in pancreatitis has been conflicting with some studies suggesting these agents might ameliorate pancreatic dysfunction by enhancing pancreatic blood flow and secretion in response to bradykinin-stimulated generation of nitric oxide from endothelium, while other studies suggest that nitric oxide potentiates pancreatic oxidative stress. Thus, there is clearly a need for well-designed clinical trials to evaluate the protective role of antioxidant therapy in acute pancreatitis.