Abstract
The incidence of the pulmonary complications in patients with acute pancreatitis is up to 60%, from mild hypoxaemia without clinical or radiological abnormalities to severe acute lung injury. Although a number of reviews has described clinical evidence of pancreatitis-associated lung injury (PALI), there is still a lack of information on potential interorgan signalling involved in the development of PALI. The present review discusses the potential factors that have been considered as candidates responsible for interorgan signalling coupling pancreatitis to lung injury. Inflammatory mediators produced from the pancreas, leucocyte system and extrapancreatic organs may directly or indirectly contribute to the high concentration in the circulation, activate circulating leucocytes, initiate the inflammatory responses of pulmonary resident cells or induce acute lung injury. Circulating leucocytes have been suggested to play an important role in interorgan signalling during the development of PALI, by producing the inflammatory mediators, reactive oxygen species and proteinases, interacting with endothelial cells, communicating with pulmonary cells and compromising the lung tissue. Extrapancreatic organs fluid, e.g. liver, PAAF and gut, may also contribute to the interorgan signalling between the pancreas and lungs. There is still a great need to clarify the specificity, sensitivity and repeatability of these candidates for interorgan signalling in PALI.
| Abbreviations | ||
| ALI | = | acute lung injury |
| AP | = | acute pancreatitis |
| ARDS | = | acute respiratory distress syndrome |
| BALF | = | bronchoalveolar lavage fluid |
| CCR | = | chemokine receptor |
| CD11b | = | Mac-1 |
| CD11b/c | = | c3bi receptor |
| CD25 | = | interleukin-2 receptor |
| CD31 | = | platelet endothelial cell adhesion molecule-1 |
| CD54 | = | intercellular adhesion molecule-1 |
| CD62L | = | L-selectin |
| CD69 | = | early activation inducer molecule |
| HLA | = | histocompatibility leucocyte antigen |
| HSP70-2 | = | heat shock protein 70-2 |
| ICAM-1 | = | intercellular cell adhesion molecule-1 |
| IL | = | interleukin |
| LPS | = | lipopolysaccharide |
| MAPK | = | mitogen-activated protein kinase |
| MCP-1 | = | monocyte chemoattractant protein-1 |
| MIF | = | macrophage migration inhibitory factor |
| MIP-1α | = | macrophage inflammatory protein-1α |
| MODS | = | multiple organ dysfunction syndrome |
| NF-κB | = | nuclear factor-κB |
| PAAF | = | pancreatitis-associated ascitic fluid |
| PAF | = | platelet activating factor |
| PALI | = | pancreatitis-associated lung injury |
| PECAM-1 | = | platelet endothelial cell adhesion molecule-1 |
| RANTES | = | regulated on activation, normal T-cell expressed and secreted |
| ROS | = | reactive oxygen species |
| STAT | = | signal transducer and activator of transcription |
| TNF-α | = | tumour necrosis factor α |
| VCAM-1 | = | vascular cell adhesion molecule-1 |
| Abbreviations | ||
| ALI | = | acute lung injury |
| AP | = | acute pancreatitis |
| ARDS | = | acute respiratory distress syndrome |
| BALF | = | bronchoalveolar lavage fluid |
| CCR | = | chemokine receptor |
| CD11b | = | Mac-1 |
| CD11b/c | = | c3bi receptor |
| CD25 | = | interleukin-2 receptor |
| CD31 | = | platelet endothelial cell adhesion molecule-1 |
| CD54 | = | intercellular adhesion molecule-1 |
| CD62L | = | L-selectin |
| CD69 | = | early activation inducer molecule |
| HLA | = | histocompatibility leucocyte antigen |
| HSP70-2 | = | heat shock protein 70-2 |
| ICAM-1 | = | intercellular cell adhesion molecule-1 |
| IL | = | interleukin |
| LPS | = | lipopolysaccharide |
| MAPK | = | mitogen-activated protein kinase |
| MCP-1 | = | monocyte chemoattractant protein-1 |
| MIF | = | macrophage migration inhibitory factor |
| MIP-1α | = | macrophage inflammatory protein-1α |
| MODS | = | multiple organ dysfunction syndrome |
| NF-κB | = | nuclear factor-κB |
| PAAF | = | pancreatitis-associated ascitic fluid |
| PAF | = | platelet activating factor |
| PALI | = | pancreatitis-associated lung injury |
| PECAM-1 | = | platelet endothelial cell adhesion molecule-1 |
| RANTES | = | regulated on activation, normal T-cell expressed and secreted |
| ROS | = | reactive oxygen species |
| STAT | = | signal transducer and activator of transcription |
| TNF-α | = | tumour necrosis factor α |
| VCAM-1 | = | vascular cell adhesion molecule-1 |