Analysis of pathophysiology in acute pancreatitis from the stand point of CARS

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Acute pancreatitis is a potentially fatal disease. Most patients develop systemic inflammatory response syndrome (SIRS), which is induced by inflammatory cytokines. Alternatively, patients with severe inflammatory insults also undergo an anti-inflammatory phase, the compensatory anti-inflammatory response syndrome (CARS). This condition is characterized by the production of cytokine antagonists and, as a result, suppression of cytokine response, which may result in immune suppression. In this project, we analyzed acute pancreatitis from the viewpoints of CARS.We elucidated the following points with this study, 1) In acute pancreatitis, abundant a mount cytokine antagonist is produced. 2) In the anaphase of the disease, de novo production of cytokines is suppressed by the cytokine antagonists. 3) Endotoxin can stimulate neutrophils accumulated in the distant organs to produce neutrophil elastase and reactive oxygen, and, as a result, provoke distant organ destruction without de novo cytokine production.