PATHOGENESIS OF ACUTE PANCREATITIS

Acute pancreatitis occurs when there is an abnormal activation of digestive enzymes within the pancreas. This occurs through inappropriate activation of inactive enzyme precursors called ZYMOGENS, especially TRYPSINOGEN. Zymogens are inactive enzymes or pro-enzymes. Pancreatic Zymogens include: Lipase, Amylase, Trypsinogen, Elastase/Pro-Elastase, Lecithinase/Phospholipase A2 and Carboxy Peptidase. The abnormal activation of Zymogens may be due to: 1)Reflux of bile into the pancreatic duct because of an obstruction by gallstones. 2)Alcohol 3)Destruction of fatty tissue around the pancreas(SAPONIFICATION), leading to the release of free fatty acids which further combine with calcium and deplete the calcium reserve in the body resulting in HYPOCALCEMIA. 4)Genetic predisposition- Mutation in SPINK-1(Serene Protease Inhibitor Kazal Type 1) gene.SPINK-1 is suppose to inhibit the activation of trypsinogen. Mutation in SPINK-1 leads to activation of trypsinogen le...