Insulin offers new hope for the treatment of acute pancreatitis

Acute pancreatitis involves the pancreas digesting itself resulting in severe abdominal pain, vomiting and systemic inflammation. Every year in the UK around 20,000 patients are diagnosed with the disease resulting in 1000 deaths. There is no immediate cure and treatment is restricted to intravenous fluid and nutritional support.

Dr Jason Bruce, from the Faculty of Life Sciences, who led the research, said "The major causes of pancreatitis include bile acid reflux from gall stones and excessive alcohol intake combined with a high fat diet. In fact, the incidence of acute pancreatitis significantly increases during the Christmas period when alcohol and fat consumption is at its highest amongst the general population. When alcohol and fat accumulate inside pancreatic acinar cells - the cells that secrete digestive enzymes into the gut - the resulting small molecules called metabolites deplete cellular energy levels and increase cellular calcium. This causes uncontrolled and catastrophic cell death and the cells burst, releasing their toxic enzymes which digest the pancreas and surrounding tissue."

However, recent research from Dr Bruce's laboratory published in the Journal of Biological Chemistry, shows that insulin, which is normally released from the beta cells of the pancreas, prevents these toxic effects of alcohol and fatty acid metabolites.

Dr Bruce and his team decided to look at insulin because it has been used successfully to treat obese pancreatitis patients by reducing fatty acids in the blood.

Diabetes makes pancreatitis worse and diabetics are at higher risk of developing pancreatitis and multiple organ failure. Moreover the incidence of pancreatitis is reduced in diabetics that receive insulin. Although tenuous, these studies suggested that insulin might have a protective role, however, it remained unclear how insulin was working. What makes the Manchester research unique is that it provides the first evidence that insulin directly protects the acinar cells, which is where the disease is initiated.

Acute pancreatitis is a sudden inflammation of the pancreas.

The pancreas is the large gland located in the upper part of the abdomen, behind the stomach. It produces digestive enzymes and hormones.

In pancreatitis, enzymes that normally are released into the digestive tract begin to damage the pancreas itself. The gland becomes swollen and inflamed. More enzymes are released into the surrounding tissues and bloodstream.

As a result, digestion slows down and becomes painful. Other body functions can be affected. The pancreas can become permanently damaged and scarred if attacks are severe, prolonged or frequent.

It is not known exactly why the enzymes start to damage the pancreas. But there are several known trigger of acute pancreatitis.

One of the most common causes of acute pancreatitis is gallstones. Gallstones that escape from the gallbladder can block the pancreatic duct. (The pancreatic duct delivers digestive enzymes from the pancreas to the small intestine.) When the pancreatic duct becomes blocked, enzymes can't flow properly. They can back up into the pancreas. This causes the pancreas to become inflamed.