Bordalo và các đồng nghiệp ban đầu cho rằng rượu viêm tụy mãn tính gây ra bởi những tác động độc hại trực tiếp sản xuất ethanol và các chất chuyển hóa của nó và các can thiệp vào chuyển hóa lipid nội bào và dẫn đến thoái hóa mỡ của các tế bào acinar tuyến tụy. | PART II Figure Causes of chronic pancreatitis due to recent progress in the identification and diagnosis of genetic factors for chronic pancreatitis the number of patients classified as having idiopathic chronic pancreatitis is decreasing. accounts for approximately 70 of patients with chronic pancreatitis with a mortality rate approaching 50 within 20-25 years due to malnutrition severe infections diabetes alcohol- and nicotine-related diseases and most commonly forgotten fatal accidents. Bordalo and colleagues initially suggested that alcoholic chronic pancreatitis is caused by the direct toxic effects of ethanol and its metabolites and that these would interfere with intracellular lipid metabolism and lead to fatty degeneration of pancreatic acinar cells. The pathologic effects of alcohol on the pancreas are however difficult to study in humans. In experimental studies ethanol and its metabolites appear to have complex short-term and long-term effects on acinar cell physiology. They can cause damage to cell membranes and affect cellular signaling pathways. Animal models which have been frequently used to investigate the effect of ethanol in vivo have demonstrated that the pancreatic injury induced by ethanol exposure is likely to be multifactorial. The mechanisms seem to include some degree of ductal hypertension decreased pancreatic blood flow oxidative stress direct acinar cell toxicity changes in protein synthesis an enhanced inflammatory response or the stimulation of fibrosis. Acute administration of alcohol in the rat results in increased injury during pancreatitis induced by a combination of pancreatic duct obstruction and hormonal hyperstimulation. Rats under chronic ethanol feeding have also more severe pancreatitis. While the generation of oxygen free radicals has been clearly demonstrated in the pancreas of rats under continuous ethanol feeding ethanol alone . without an additional diseaseinducing stimulus does not cause pancreatitis. .
