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Alcohol, inflammation and gene modifications in chronic pancreatitis.

Department of Digestive Diseases and Internal Medicine, Sant'Orsola-Malpighi Hospital. Bologna, Italy The etiology of chronic pancreatitis in Western countries is associated with chronic alcohol abuse in a high percentage of cases. In fact, we found that, in 190 Italian patients with proven chronic pancreatitis who were studied in the 2005, the etiology was alcohol abuse (more than 80 g/day for at least 5 years) in 77.4% of the cases and due to other causes in 5.8% (hereditary pancreatitis in 2.6%, pancreatic malformation in 2.1%, cystic fibrosis transmembrane conductance regulator gene mutation in 0.5%, autoimmune pancreatitis in 0.5%); in 16.8% of the cases, a definite etiology of the pancreatitis was not recognized [1]. Although alcohol abuse is the main factor associated with chronic pancreatitis development, the pathological mechanisms involved in the initiation the disease remain obscure. One of the reasons for our difficulty in understanding the trigger mechanism between alcohol abuse and chronic pancreatic damage is the lack of animal and cellular models simulating the lesions such as those observed in humans. Gukovsky