Ilaria Pergolini, Stephan Schorn, Helmut Friess, Ihsan Ekin Demir
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引用次数: 0
Abstract
Introduction: As natural calcium (Ca) antagonist, magnesium (Mg) seems to counteract Ca-signaling pathways involved in the intracellular protease activation leading to acute pancreatitis. We systematically reviewed the current literature to investigate the role of Mg in the pathogenesis of acute pancreatitis and its possible use in detecting, predicting, and preventing acute pancreatitis.
Methods: A systematic search was performed in PubMed/Scopus/Web of Science to identify in vivo and in vitro studies reporting data on Mg in acute pancreatitis.
Results: Twelve studies were included. Due to their heterogeneity, we conducted a review without the intent of inference. Mg deficiency in pancreatic acinar cells seems to be frequently associated with serum hypocalcemia and acute pancreatitis. Mg seems to contrast intracellular Ca accumulation which induces premature enzyme activation and acute pancreatitis. Several in vivo and in vitro experiments showed beneficial effects of Mg supplementation in counteracting Ca-signaling pathways and subsequent pathological events. Moreover, a recent randomized trial demonstrated the efficacy of Mg supplementation in reducing the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in high-risk patients.
Conclusion: Mg is a natural antagonist of Ca-signaling pathways and, when deficient, predisposes to acute pancreatitis. Mg supplementation may be useful to prevent acute pancreatitis in many contexts, such as post-ERCP or after pancreatic surgery. The heterogeneity of the included studies represents an important limitation that may hinder robust conclusions.
简介:作为天然的钙(Ca)拮抗剂,镁(Mg)似乎可以抵消参与细胞内蛋白酶激活导致急性胰腺炎的Ca信号通路。我们系统地回顾了目前的文献,以研究镁在急性胰腺炎发病机制中的作用,以及镁在检测、预测和预防急性胰腺炎中的可能用途:方法:在PubMed/Scopus/Web of Science中进行了系统性检索,以确定报道镁在急性胰腺炎中作用的体内和体外研究数据:结果:共纳入 12 项研究。由于这些研究存在异质性,我们在不进行推论的情况下进行了综述。胰腺针叶细胞的镁缺乏似乎经常与血清低钙血症和急性胰腺炎有关。镁似乎与细胞内的钙积累形成对比,而钙积累会诱发过早的酶激活和急性胰腺炎。一些体内和体外实验表明,补充镁对抵消钙信号通路和随后的病理事件有益。此外,最近的一项随机试验表明,补充镁能有效降低高危患者内镜逆行胰胆管造影术(ERCP)后胰腺炎的发病率:结论:镁是钙信号通路的天然拮抗剂,缺乏时易引发急性胰腺炎。在许多情况下,例如胃食管返流术后或胰腺手术后,补充镁可能有助于预防急性胰腺炎。纳入研究的异质性是一个重要的局限性,可能会妨碍得出可靠的结论。
期刊介绍:
This interdisciplinary journal is unique in its field as it covers the principles of both gastrointestinal medicine and surgery required for treating abdominal diseases. In each issue invited reviews provide a comprehensive overview of one selected topic. Thus, a sound background of the state of the art in clinical practice and research is provided. A panel of specialists in gastroenterology, surgery, radiology, and pathology discusses different approaches to diagnosis and treatment of the topic covered in the respective issue. Original articles, case reports, and commentaries make for further interesting reading.