Latest Advances in Pancreatic Diseases

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (1 August 2021) | Viewed by 9622

Special Issue Editor


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Guest Editor
Institute of Biopathology and Regenerative Medicine (IBIMER), University of Granada, Granada, Spain
Interests: pancreatic ductal adenocarcinoma; chronic pancreatitis; peripheral blood; biomarkers; diagnosis; RNASeq; metabolomics

Special Issue Information

Dear Colleagues,

Despite decades of effort, the diagnosis and management of the diseases of the pancreas is still a challenge due to the inaccessibility of this organ. There are multiple methods to evaluate the pancreas, but to date, few of them confirm the presence of any pancreatic disease or can help in monitoring treatment success.  

Pancreatic cancer remains a lethal disease due to its rapid progression and early metastasis, with a life expectancy of less than 6 months and a 5-year survival rate of around 5%. Pancreatitis is an inflammatory disease of the pancreas. Its diagnosis, mainly based on the presence of morphological or functional changes, is difficult because no standard diagnostic criteria or method of diagnosing this pathology have been established. Diabetes is a disease characterized by β-cell destruction or dysfunction, resulting in progressive hyperglycemia. Finally, exocrine pancreatic insufficiency results from destruction of the pancreatic parenchyma, making it impossible to maintain the minimum production levels of digestive enzymes.

As early diagnosis is the best way to improve the clinical outcome of these patients, the lack of robust, accurate, and non-invasive methods to detect early stages of pancreatic diseases represents the most important obstacle to the improvement of outcomes. The present Issue aims to publish studies that propose new diagnostic or prognostic tools in the battle against pancreatic diseases.

Dr. Octavio Caba
Guest Editor

Manuscript Submission Information

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Keywords

  • pancreatic diseases
  • pancreatic cancer
  • pancreatitis
  • diabetes
  • exocrine pancreatic insufficiency
  • biomarkers
  • diagnosis
  • prognosis

Published Papers (2 papers)

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Research

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9 pages, 1068 KiB  
Article
Untargeted Metabolomics for the Diagnosis of Exocrine Pancreatic Insufficiency in Chronic Pancreatitis
by Caridad Díaz, Cristina Jiménez-Luna, Carmelo Diéguez-Castillo, Ariadna Martín, José Prados, José Luis Martín-Ruíz, Olga Genilloud, Francisca Vicente, José Pérez del Palacio and Octavio Caba
Medicina 2021, 57(9), 876; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57090876 - 26 Aug 2021
Cited by 3 | Viewed by 1993
Abstract
Background and Objectives: The clinical manifestations and course of chronic pancreatitis (CP) are often nonspecific and variable, hampering diagnosis of the risk of exocrine pancreatic insufficiency (EPI). Development of new, reproducible, and non-invasive methods to diagnose EPI is therefore a major priority. [...] Read more.
Background and Objectives: The clinical manifestations and course of chronic pancreatitis (CP) are often nonspecific and variable, hampering diagnosis of the risk of exocrine pancreatic insufficiency (EPI). Development of new, reproducible, and non-invasive methods to diagnose EPI is therefore a major priority. The objective of this metabolomic study was to identify novel biomarkers associated with EPI. Materials and Methods: We analyzed 53 samples from patients with CP, 32 with and 21 without EPI, using an untargeted metabolomics workflow based on hydrophilic interaction chromatography coupled to high-resolution mass spectrometry. Principal component and partial least squares-discriminant analyses showed significant between-group differentiation, and univariate and multivariate analyses identified potential candidate metabolites that significantly differed between samples from CP patients with EPI and those without EPI. Results: Excellent results were obtained using a six-metabolic panel to diagnose the presence of EPI in CP patients (area under the ROC curve = 0.785). Conclusions: This study confirms the usefulness of metabolomics in this disease setting, allowing the identification of novel biomarkers to differentiate between the presence and absence of EPI in CP patients. Full article
(This article belongs to the Special Issue Latest Advances in Pancreatic Diseases)
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Review

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10 pages, 722 KiB  
Review
State of the Art in Exocrine Pancreatic Insufficiency
by Carmelo Diéguez-Castillo, Cristina Jiménez-Luna, Jose Prados, José Luis Martín-Ruiz and Octavio Caba
Medicina 2020, 56(10), 523; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56100523 - 07 Oct 2020
Cited by 19 | Viewed by 7068
Abstract
Exocrine pancreatic insufficiency (EPI) is defined as the maldigestion of foods due to inadequate pancreatic secretion, which can be caused by alterations in its stimulation, production, transport, or interaction with nutrients at duodenal level. The most frequent causes are chronic pancreatitis in adults [...] Read more.
Exocrine pancreatic insufficiency (EPI) is defined as the maldigestion of foods due to inadequate pancreatic secretion, which can be caused by alterations in its stimulation, production, transport, or interaction with nutrients at duodenal level. The most frequent causes are chronic pancreatitis in adults and cystic fibrosis in children. The prevalence of EPI is high, varying according to its etiology, but it is considered to be underdiagnosed and undertreated. Its importance lies in the quality of life impairment that results from the malabsorption and malnutrition and in the increased morbidity and mortality, being associated with osteoporosis and cardiovascular events. The diagnosis is based on a set of symptoms, indicators of malnutrition, and an indirect non-invasive test in at-risk patients. The treatment of choice combines non-restrictive dietary measures with pancreatic enzyme replacement therapy to correct the associated symptoms and improve the nutritional status of patients. Non-responders require the adjustment of pancreatic enzyme therapy, the association of proton pump inhibitors, and/or the evaluation of alternative diagnoses such as bacterial overgrowth. This review offers an in-depth overview of EPI in order to support the proper management of this entity based on updated and integrated knowledge of its etiopathogenesis, prevalence, diagnosis, and treatment. Full article
(This article belongs to the Special Issue Latest Advances in Pancreatic Diseases)
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