Researchers working on acute pancreatitis have made exciting progress in our understanding of the disease. Professor Damian Mole at the University of Edinburgh and his collaborators have found that patients with acute pancreatitis can be allocated into four different groups and that which group a patient is might have an impact on how severe their pancreatitis attack is and how they should be treated.
Acute pancreatitis is an inflammation of the pancreas that can spread to other organs in the body, such as the lungs, liver and kidney. When the inflammation spreads through the body patients can become extremely ill and sometimes die. However, in other cases of acute pancreatitis patients can recover quickly. It is not clear why some patients have a more severe response to acute pancreatitis.
Acute pancreatitis has various causes and triggers, including gallstones, excessive alcohol consumption, trauma, damage during endoscopy to the pancreas, some viral infections, certain venoms and specific prescription medicines. These factors lead to damage to the cells of the pancreas, which in turn cause an inflammatory response in the body. This inflammation can be mild, moderate or severe. However, patients with acute pancreatitis do not always align to this disease model and can sometimes have a severe response despite their pancreas not showing extensive damage.
Prof Mole and his collaborators were keen to look at patients with acute pancreatitis under a different lens. They proposed that acute pancreatitis could be actually separated into subtypes and that each subtype might have a different clinical outcome (for example a more or less severe attack) and respond differently to the same treatment.
To test this idea Prof Mole and his collaborators took a novel approach. They analysed clinical information alongside data obtained from patients with acute pancreatitis, such as the behavior of their genes (gene expression) and the levels of proteins and other molecules in their blood. To analyse all this information the team used computational analysis: powerful mathematical models running on computers. Using this approach they measured a set of parameters and managed to identify the four different subtypes, or groupings, among the patients.
Although these findings are too preliminary to explore in a larger study yet, they improve our understanding of acute pancreatitis and provide an insight into why patients have such different responses to the disease. This in turn could allow a more personalised and effective treatment for each patient.
This is one of the aims of Prof Mole and his collaborators, who said:
“Diagnosing and treating each individual person with acute pancreatitis according to their own personal characteristics – especially their genes, proteins and metabolites – and how those individual characteristics change during an episode of acute pancreatitis – is a really exciting new area in which my team is leading the way in the UK, and internationally. In the near future this is going to allow us to identify treatment opportunities in each specific individual who gets pancreatitis, and focus those specific treatments to individual people who stand to benefit most from that treatment. Likewise, for other people, a different treatment might be more effective – we call this precision medicine – and we are doing everything we can to make it a reality in pancreatitis.”
Guts UK has supported research into pancreatitis for years since we received a generous donation on behalf of a pancreatitis patient, Amelie Waring. Since 1981 the Guts UK Amelie Waring Fellowship has helped to gain a better understanding of the disease. Guts UK has supported the work of professor Damian Mole in the past, as well as other members of his team. In 2018 Guts UK awarded the Amelie Waring Fellowship to Dr James O’Kelly, who will start work at the University of Edinburgh in 2019 exploring a potential new treatment for pancreatitis.