[Inflammatory diseases of the pancreas: what new do we know about the mechanisms of their development in the 21st century?]

[Cell therapy for destructive pancreatitis]

OBJECTIVE

To evaluate therapeutic efficacy of mesenchymal stem cells in patients with severe acute pancreatitis.

MATERIAL AND METHODS

There were 60 patients with severe acute pancreatitis randomized into 2 groups: the first group (n=30) - endoscopic surgical treatment, mean age 44.7±2.93 years (18 (60.0%) males and 12 (40.0%) females); the second group (n=30) - complex therapy (standard treatment + cell therapy), mean age 50.8±3.8 years (16 (53.3%) men and 14 (46.7%) women). Taxation of endogenous intoxication, immunity state and regional microcirculation were assessed. Genetic analysis of eNOS (C774T) gene polymorphism was also carried out.

RESULTS

Early period of acute severe pancreatitis is accompanied by significant disorders of homeostasis (endogenous intoxication, immune imbalance, severe disorders of regional microcirculation). Genetic analysis showed that polymorphic genotype (T774T) of the endothelial NO synthase gene in a larger percentage (66.7-71.6%, p=0.001) occur in patients with severe acute pancreatitis and more severe homeostatic disorders (p<0.05). Inclusion of mesenchymal stem cells into standard therapy in early phase of acute severe pancreatitis makes it possible to purposefully and relatively quickly exert its effect on abnormal processes of homeostasis, inhibiting toxemic phenomenon, restoring immune response, and improving microcirculation. A particularly positive therapeutic effect of the drug is observed in patients with the eNOS gene mutation (T774T).

CONCLUSION

Mesenchymal stem cell drugs are advisable in early period of acute pancreatitis, mainly in patients with severe forms of disease.