The potential role of therapeutic cytokine manipulation in acute pancreatitis

The central, detrimental role of the inflammatory cytokines, interleukin-l and tumor necrosis factor, and the biologically active phospholipid platelet activating factor in the pathogenesis of AP has been established over the past 8 years. Many antagonists to these mediators have been used successfully in the laboratory setting, and are currently being examined in prospective randomized trials. The effectiveness of any antagonist depends not only on its ability to block a particular inflammatory mediator or mediators but also on its administration early in the course of the pancreatitis before pancreatic necrosis or organ dysfunction occur.