Pancreatology最新文献

{"title":"When does delay in treatment impact survival from pancreatic cancer?","authors":"Bettina M. Rau , John A. Windsor","doi":"10.1016/j.pan.2025.01.006","DOIUrl":"10.1016/j.pan.2025.01.006","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 191-192"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding “Early detection of pancreatic cancer: Study design and analytical considerations in biomarker discovery and early phase validation studies”","authors":"Stuart G. Baker, Ruth Etzioni","doi":"10.1016/j.pan.2025.01.009","DOIUrl":"10.1016/j.pan.2025.01.009","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 284-285"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical pancreatic exocrine insufficiency is associated with osteopathy in patients with chronic pancreatitis: Implications for management","authors":"Mehul Gupta ,&nbsp;Shallu Midha ,&nbsp;Vikas Sachdeva ,&nbsp;Jairam Singh ,&nbsp;Shivam Pandey ,&nbsp;Chetanya Mittal ,&nbsp;Varun Teja ,&nbsp;Tanmay Vajpai ,&nbsp;Anugrah Dhooria ,&nbsp;Nikhil Tandon ,&nbsp;Soumya Jagannath ,&nbsp;Pramod Kumar Garg","doi":"10.1016/j.pan.2024.12.017","DOIUrl":"10.1016/j.pan.2024.12.017","url":null,"abstract":"<div><h3>Background and aims</h3><div>Patients with chronic pancreatitis (CP) may develop pancreatic exocrine insufficiency (PEI) but data regarding subclinical PEI are scarce. Our objective was to detect subclinical PEI in patients with CP and its functional consequences.</div></div><div><h3>Methods</h3><div>We prospectively included patients with CP from April 2018–December 2021. Mild PEI and severe PEI were diagnosed if fecal elastase (FE) was 100–200 μg/g and &lt;100 μg/g stool respectively. Vitamin levels and DEXA scan were done to assess functional consequences of PEI. Presence of subclinical PEI in CP (low FE-1 but without steatorrhea) with consequent osteopathy was the primary outcome.</div></div><div><h3>Results</h3><div>Of 120 patients with CP, subclinical PEI (low FE-1 but no steatorrhea) was present in 84/120(70%) patients: 6/8(75%) in early CP, 41/53(77%) in definite CP and 37/55(67.2%) in advanced CP. Overall, 72.1% patients had osteopathy including 53(62%) among patients with subclinical PEI. There was no difference in osteopathy between subclinical and severe PEI. Patients with severe PEI had lower vitamin A levels as compared to mild PEI and no PEI patients [1.3 ± 0.5 mg/ml vs. 1.7 ± 0.6 mg/ml vs. 1.8 ± 0.5 mg/ml; p = 0.04]. There was no difference in vitamin D levels. Osteopathy was present in 40/56 (71.4%) in advanced, 26/56 (46.4%) in definite and 2/8 (25%) in early CP patients (p = 0.09). On multivariable analysis, patients with advanced CP had the higher risk of osteopathy (odds ratio 7.6, 95% CI 1.9–29.7).</div></div><div><h3>Conclusions</h3><div>Subclinical PEI was present even in early CP with increased risk of osteopathy and fat-soluble vitamin deficiency.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 193-199"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depth of response in patients with locally advanced pancreatic cancer treated with first-line chemotherapy: A supplementary analysis of JCOG1407","authors":"Taro Shibuki ,&nbsp;Masafumi Ikeda ,&nbsp;Masayuki Yokoyama ,&nbsp;Yusuke Sano ,&nbsp;Junji Furuse ,&nbsp;Satoshi Kobayashi ,&nbsp;Akihiro Ohba ,&nbsp;Akiko Todaka ,&nbsp;Yoshiki Horie ,&nbsp;Kazuhiko Shioji ,&nbsp;Masashi Kanai ,&nbsp;Tomohiro Nishina ,&nbsp;Yusuke Kumamoto ,&nbsp;Nao Fujimori ,&nbsp;Akio Katanuma ,&nbsp;Yukiko Takayama ,&nbsp;Hidetaka Tsumura ,&nbsp;Haruo Miwa ,&nbsp;Masato Ozaka ,&nbsp;Makoto Ueno","doi":"10.1016/j.pan.2025.02.005","DOIUrl":"10.1016/j.pan.2025.02.005","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Depth of response (DpR; maximum % reduction from baseline in sum of the target lesion diameters) has demonstrated potential in predicting prognosis in several malignancies. However, its role in locally advanced pancreatic cancer (LAPC) is still unclear. In JCOG1407, modified FOLFIRINOX (mFOLFIRINOX) and gemcitabine plus nab-paclitaxel (GnP) exhibited comparable efficacy for LAPC. In this exploratory analysis using the data of JCOG1407, we focused on the association between DpR and prognosis.</div></div><div><h3>Methods</h3><div>DpR was classified into three groups at the tertile point and patients’ backgrounds and survival were compared. The impact of DpR on survival outcomes was evaluated using the multivariable Cox proportional hazard model.</div></div><div><h3>Results</h3><div>Of the 126 patients enrolled in JCOG1407, 109 patients were included, categorized into three DpR groups: T1 (&lt;−37.2 %), T2 (−37.2 to −13.6 %), and T3 (&gt;−13.6 %). The median DpR was significantly greater in the GnP arm than in the mFOLFIRINOX arm (−28.9 vs. −22.7 %, P = 0.041). Median duration of response tended to be shorter in the GnP arm than in the mFOLFIRINOX arm, although the difference was not significant (5.3 vs. 8.2 months, P = 0.132). Greater DpR (T1) had a significantly larger impact on better progression-free survival (PFS) and overall survival (OS) than T3, with the hazard ratio of 0.469 (95 % confidence interval [CI] 0.268–0.821, P = 0.008), and 0.398 (95 % CI 0.217–0.728, P = 0.003), respectively.</div></div><div><h3>Conclusions</h3><div>mFOLFIRINOX and GnP had similar OS, it is noteworthy that the regimens exhibited differences in DpR, with GnP leading to greater DpR. Greater DpR are associated with improved survival in patients with LAPC.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 275-283"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving trends in interventions and outcomes for acute biliary pancreatitis during pregnancy: A two-decade analysis","authors":"Ayushi Jain ,&nbsp;Yevgeniya Gokun ,&nbsp;Phil A. Hart ,&nbsp;Mitchell L. Ramsey ,&nbsp;Georgios I. Papachristou ,&nbsp;Samuel Han ,&nbsp;Peter J. Lee ,&nbsp;Hamza Shah ,&nbsp;Jordan Burlen ,&nbsp;Raj Shah ,&nbsp;Erica Park ,&nbsp;Somashekar G. Krishna","doi":"10.1016/j.pan.2025.02.006","DOIUrl":"10.1016/j.pan.2025.02.006","url":null,"abstract":"<div><h3>Background/objectives</h3><div>Cholelithiasis is the most common cause of acute pancreatitis in pregnancy. We analyzed trends in acute biliary pancreatitis (ABP) among pregnant women over the past two decades to evaluate changes in outcomes, including the incidence of severe acute pancreatitis, mortality rates, and hospital length of stay.</div></div><div><h3>Methods</h3><div>Using the National Inpatient Sample, we identified adult women of childbearing age (age 18–50 years) with hospitalization for ABP from 2002 to 2020. Trends were analyzed using Cochran-Armitage and F-tests. Multivariable binary logistic regression was used to evaluate the outcome of severe acute pancreatitis (SAP).</div></div><div><h3>Results</h3><div>45,064 pregnant and 212,009 non-pregnant women were hospitalized for ABP (2002–2020), with a significant increase in ABP during pregnancy (14.1 %→17.8 %; p &lt; 0.001). Trend analyses in the pregnant cohort revealed increasing age (mean 27  →  28.1 years; p &lt; 0.001), Class-III obesity (0.7 %→7.8 %; p &lt; 0.001), comorbidities (Elixhauser index ≥3) (2.9 %→11.2 %; p &lt; 0.001), and SAP (2.2 %→5.0 %; p &lt; 0.001). Mortality remained very low (&lt;0.01 %). Performance of ERCP (22.2 %→26.5 %; p &lt; 0.001) and cholecystectomy (41.0 %→54.1 %; p &lt; 0.001) increased while duration of hospitalization decreased (Mean 4.9  →  3.6 days; p &lt; 0.001).</div><div>Multivariable analysis revealed that the development of SAP was associated with Black race (OR 1.70, 95 % CI: 1.10–2.63) and comorbidities (OR 5.10, 95 % CI 3.64–7.14).</div></div><div><h3>Conclusions</h3><div>Pregnant women represent a significant portion of hospitalized ABP cases, paralleling increases in age, comorbidities, and obesity rates. Racial disparities are linked to higher odds of SAP, though comorbidities have a dominant effect. There has been an increase in guideline-recommended procedures (ERCP and cholecystectomy); however, further research is needed to address the implementation gap, considering the increased complexity of pregnant women with ABP.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 2","pages":"Pages 200-207"},"PeriodicalIF":2.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations from the European guidelines for the diagnosis and therapy of pancreatic exocrine insufficiency.","authors":"Miroslav Vujasinovic, Daniel de la Iglesia, J Enrique Dominguez-Muñoz, J Matthias Löhr","doi":"10.1016/j.pan.2025.02.015","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.015","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic exocrine insufficiency (PEI) is defined as a reduction in pancreatic exocrine secretion below a level that allows normal digestion of nutrients. Pancreatic disease and pancreatic surgery are the main causes of PEI, but other conditions can affect the digestive function of the pancreas.</p><p><strong>Methods: </strong>In collaboration with European Digestive Surgery (EDS), European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), European Society for Clinical Nutrition and Metabolism (ESPEN), European Society of Digestive Oncology (ESDO), and European Society of Primary Care Gastroenterology (ESPCG) the working group developed European guidelines for the diagnosis and therapy of PEI. United European Gastroenterology (UEG) provided both endorsement and financial support for the development of the guidelines.</p><p><strong>Results: </strong>Recommendations covered topics related to the clinical management of PEI: concept, pathogenesis, clinical relevance, general diagnostic approach, general therapeutic approach, PEI secondary to chronic pancreatitis, PEI after acute pancreatitis, PEI associated with pancreatic cancer, PEI secondary to cystic fibrosis, PEI after pancreatic surgery, PEI after esophageal, gastric, and bariatric surgery, PEI in patients with type 1 and type 2 diabetes, and PEI in other conditions.</p><p><strong>Conclusions: </strong>The European guidelines for the diagnosis and therapy of PEI provide evidence-based recommendations concerning key aspects of the etiology, diagnosis, therapy, and follow-up, based on current available evidence. These recommendations should serve as a reference standard for existing management of PEI and as a guide for future clinical research. This article summarizes the recommendations and statements.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early response evaluation using CT and CA 19-9 in patients with pancreatic cancer of all stages undergoing first-line FOLFIRINOX treatment.","authors":"Seung-Seob Kim, Seokho Kim, Jung Hyun Jo, Hee Seung Lee, Jae-Joon Chung, Seungmin Bang, Mi-Suk Park","doi":"10.1016/j.pan.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.007","url":null,"abstract":"<p><strong>Objectives: </strong>To propose an effective integration method for CT and carbohydrate antigen (CA) 19-9 responses applicable to patients with all stages of pancreatic ductal adenocarcinoma (PDAC) treated with first-line FOLFIRINOX.</p><p><strong>Methods: </strong>We retrospectively identified patients with PDAC who underwent first-line FOLFIRINOX treatment at a single tertiary hospital between 2017 and 2020. Those with baseline and 8-week follow-up CT scans were included in the CT response dataset. Patients with both CT and CA 19-9 information comprised the CT/CA 19-9 response dataset. CT reports and CA 19-9 levels at baseline and 8-week follow-up were collected. CT response was based on Response Evaluation Criteria in Solid Tumors. CA 19-9 changes were determined as CA 19-9 levels normalized (<37 U/mL), decreased (>37 U/mL), or increased. Overall survival (OS) was compared.</p><p><strong>Results: </strong>In the CT response dataset (n = 392), patients with progressive disease (PD; n = 44) exhibited shorter OS than stable disease (SD; n = 228; P = .01) or partial response (PR; n = 120; P = .001). OS did not significantly differ between PR and SD (P = .40). In the CT/CA 19-9 response dataset (n = 242), integrated CT and CA 19-9 responses revealed the shortest OS in patients with either PD or increased CA 19-9 (n = 74; median OS, 14.3 months), followed by PR/SD with decreased CA 19-9 (n = 113; median OS, 19.8 months; P = .003), and PR/SD with normalized CA 19-9 (n = 55; median OS, 23.6 months; P = .04).</p><p><strong>Conclusion: </strong>Our combined evaluation of CT and CA 19-9 responses successfully stratified the survival of patients with PDAC treated with FOLFIRINOX, irrespective of disease stage.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concealed pancreatic cancer in acute pancreatitis: Early MRCP and EUS surveillance improves prognosis and identifies high-risk patients.","authors":"Kentaro Yamao, Mamoru Takenaka, Akihiro Yoshida, Tomohiro Yamazaki, Shunsuke Omoto, Kosuke Minaga, Ken Kamata, Yoshihisa Takada, Kota Uetsuki, Tadashi Iida, Yasuyuki Mizutani, Takuya Ishikawa, Hiroki Kawashima, Masatoshi Kudo","doi":"10.1016/j.pan.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.013","url":null,"abstract":"<p><strong>Background/objectives: </strong>Acute pancreatitis (AP) may obscure small pancreatic cancers (PCs) on computed tomography during the acute phase. Surveillance with magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS) may enhance early detection and improve patient outcomes. This study evaluated the impact of early MRCP/EUS surveillance on PC outcomes in AP patients and identified high-risk subgroups for early screening.</p><p><strong>Methods: </strong>We retrospectively analyzed 1562 AP patients treated between 2010 and 2021, categorizing them into early surveillance (MRCP/EUS within three months of AP onset; n = 760) and nonearly surveillance groups (n = 802). Key outcomes included time to PC diagnosis, surgical resection rate, tumor stage, and overall survival. Multivariate analysis was performed to identify risk factors for concealed PC in AP patients.</p><p><strong>Results: </strong>Among 27 PC cases analyzed, the early surveillance group achieved significantly earlier diagnosis, higher surgical resection rates, increased detection of early-stage PC, and improved overall survival compared with the nonearly surveillance group. Multivariate analysis revealed that subthreshold main pancreatic duct (MPD) dilation (≥2.5 mm) and moderately severe AP were significant predictors of PC.</p><p><strong>Conclusions: </strong>Early MRCP/EUS surveillance in AP patients facilitates timely detection of occult PC and enhances patient prognosis. These findings support prioritizing early surveillance for AP patients with subthreshold MPD dilation and moderately severe disease. Further large-scale studies are warranted to validate these strategies in clinical practice.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory markers in predicting survival in pancreatic cancer: A Systematic review and Meta-Analysis.","authors":"Rinrada Worapongpaiboon, Noppachai Siranart, Patavee Pajareya, Somkiat Phutinart","doi":"10.1016/j.pan.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.014","url":null,"abstract":"<p><strong>Introduction: </strong>Determining an accurate prognosis for pancreatic cancer (PC) can pose significant challenges. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) has been used as prognostic factors to predict outcomes in patients with gastrointestinal cancer. This study aims to reveal the prognostic value of NLR and PLR on survival outcomes and risk of metastasis in PC.</p><p><strong>Methods: </strong>NLR and PLR was investigated for its potential to predict survival outcomes in pancreatic ductal adenocarcinoma (PDAC) and pancreatic neuroendocrine tumor (PNET). For pancreatic cystic neoplasm (PCN), we investigated the potential for inflammatory markers to predict malignancy. Subgroup analysis was performed for tumor resectability, marker cut-off value (COV), and conducted location. Hazard ratios (HRs) and odds ratios (ORs) were pooled and analyzed using a random-effects model.</p><p><strong>Results: </strong>A total of 105 studies included with a total of 20,138 patients. In PDAC, elevated NLR levels were significantly associated with poorer outcomes of overall survival (OS), progression-free survival (PFS), and recurrence-free survival (RFS) in multivariable analysis (HR 1.79, 1.74, and 1.91, respectively). Similarly, elevated PLR levels in PDAC were also associated with poorer OS and RFS in multivariable analysis (HR 1.33 and 1.94), respectively. For PNET, NLR was significantly associated with OS and RFS in multivariable analysis (HR 2.57 and 3.05, respectively). Furthermore, NLR and PLR show significant association with malignancy in PCN (OR 3.07 and HR 2.42, respectively).</p><p><strong>Conclusion: </strong>NLR and PLR effectively predicted PC outcomes and hold potential for evaluating therapeutic responses and identifying candidates for additional treatment strategies in advanced disease.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating cyclophilin A levels elevate in animal models and can predict mortality in patients with acute pancreatitis.","authors":"Wenhao Cai, Priyanka Bhattacharya, Yuying Li, Yongjian Wen, Na Shi, Tingting Liu, Qing Xia, Robert Sutton, Wei Huang, Rajarshi Mukherjee","doi":"10.1016/j.pan.2025.02.012","DOIUrl":"https://doi.org/10.1016/j.pan.2025.02.012","url":null,"abstract":"<p><strong>Background/objectives: </strong>Cyclophilin A (CypA) is released into the blood following cellular injury and correlates with acute pancreatitis (AP) severity, however, investigations into circulating CypA in experimental AP and hypertriglyceridaemia-associated AP (HTG-AP) prevalent cohorts are lacking.</p><p><strong>Methods: </strong>C57Bl/6 mice received 4, 8, and 12 caerulein injections to induce escalating severity of AP models (CER-AP). Mice were sacrificed 1 h after the last injection of caerulein to assess severity of CER-AP through biochemical and histopathological analyses, and serum CypA levels were also measured. Golden Syrian hamsters fed with a high-cholesterol/high-fat diet were given 10 caerulein injections to induce experimental HTG-AP to assess severity and serum CypA. Human blood plasma samples taken within 24 h after admission from a patient cohort with a predominance of HTG-AP cases, stored in a prospectively collected AP Biobank, were assessed for plasma CypA levels and correlated with clinical data.</p><p><strong>Results: </strong>In mice, CER-AP models showed significantly increased pancreatic histopathological scores and biochemical parameters, with severity highest after 12 caerulein injections. Serum CypA levels were significantly higher in all CER-AP models compared to controls. In hamsters, CypA levels were significantly higher in HTG-AP model than controls. In AP patients, CypA levels in non-haemolytic plasma samples varied by aetiology, with the highest levels in HTG-AP, corresponding to HTG levels and AP severity. ROC analysis revealed CypA ≥9.9 ng/ml as a significant predictor of mortality (AUC = 0.865).</p><p><strong>Conclusion: </strong>Circulating CypA levels are significantly increased in mouse CER-AP and hamster HTG-AP models. We have identified a novel association of raised plasma CypA levels with severity of HTG-AP and confirmed its significant prognostic ability to predict mortality in AP patients.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}