Biomarkers of acute and chronic pancreatitis

Pancreatitis and pancreatic cancers are very serious diseases with very poor prognosis, and many patients die before even reaching the clinical stage. Therefore, identification of reliable and specific biomarkers at early stages of pancreatitis and pancreatic cancers could be the key to their early prevention and therapy. In this chapter, currently used and putative biomarkers of acute and chronic pancreatitis are summarized. Serum total amylase and lipase in combination or individually remain the most widely used biomarkers for clinical diagnostics of acute pancreatitis. Definitely, lipase assay has an advantage over amylase in clinical diagnostics of acute pancreatitis rather than chronic pancreatitis and appears to have greater specificity. However, imaging technologies strongly support the diagnosis of both acute and chronic pancreatitis. Identification and development of biomarkers of chronic pancreatitis remain challenging because of the impaired secretory component of the exocrine pancreas due to slow destruction of the gland during chronic pancreatitis, particularly at later stages. Therefore, the focus of future research lies in identification of molecular biomarkers by utilizing proteomic, metabolomic, and microRNA array technologies in well-defined experimental models followed by their confirmation in large cohorts of patient populations with acute and various stages of chronic pancreatitis.