Clinics related to acute pancreatitis wonder whether IFN-[gamma] can attenuate pancreatic injury or not.
Acute pancreatitis (AP) is an inflammatory disease of the
pancreatic tissue associated with little or no fibrosis of the gland.
Continued clinical and experimental studies/trials are important for
understanding AP pathogenesis and its current treatment approaches. Meng
et al.  contribute to our knowledge on NF-[kappa]B and cytokines
IL-18 and IL-27 in experimental AP at 6 h, 12 h, 24 h and 48 h after
IFN-[gamma] treatment. However, the messages are implicit both in
presentation of results and in the paper itself are complicated by the
fact that is likely to be data interferences in relation to AP treated
with IFN-[gamma]. For instance, the conclusion that "the increase
in NF-[kappa]B and IL-18 may exert influence on pro-inflammatory
cytokines to deteriorate inflammation in the pancreas. Thus, to control
the IFN-[gamma] might has promise to attenuate pancreatitis ...
IFN-[gamma] treatment might be associated with JAK-STAT mediated
transcription activation' is based on a speculative opinion. There
are just similar sentences taken from different articles excepting for
cited references in introduction section, the amount of the application
dose for IFN-[gamma] is unknown and the authors are no interpretation
their own findings on discussion section in this study. According to
this study, serum amylase level, the edema, the NF-[kappa]B and TNF-a
expression in the pancreas were significantly increased in the treatment
of IFN-[gamma] after AP. As a result of these findings, the application
of IFN-[gamma] can cause a deleterious effect within the pancreas in the
course of AP. On the other hand, Hayashi et al.  reported that
recombinant murine IFN-[gamma] therapy markedly alleviated acute
pancreatitis when administered 4 hours in mice, with reduced NF-[kappa]B
activation and COX-2 expression. Thus, IFN-[gamma] may possess
anti-inflammatory effects on AP by repression of the proinflammatory
consequences of NF-[kappa]B activation. In addition, Rau et al.  have
indicated that immunostimulative treatment with recombinant rat
IFN-[gamma] attenuated the progression of intrapancreatic necrosis
within the first 24 hours after AP induction along with a substantial
reduction of subsequent neutrophil tissue infiltration and decreased
TNF-a at the late stage of AP. Moreover, plasma IFN-[gamma]
concentration is known to increase at the early stage of disease in mild
and severe AP patients compared with healthy controls. Therefore,
immunostimulative regime could be more effective during the late stage
of this disease when infectious complications and immunoparalysis might
be a dominant cause of mortality in the course of AP. Actually,
pharmacological therapies are limited in the treatment of AP, and none
of the therapeutic agents used for therapy are effectively curative.
Regardless of AP severity, hospitalization of the patients with
suspected acute pancreatitis for observation and diagnostic study is
generally mandatory. After the diagnosis, patients with moderate to
severe disease should be transferred to the ICU for observation, and
supportive treatments and interventions. Treatment may change depending
on the etiology and severity of the disease. Antibiotic therapy,
peritoneal lavage, sphincterotomy with ERCP and even surgical operations
can be applied [4, 5]. Novel effective therapeutic strategies in the
treatment of AP may be evolved.
DECLARATION OF INTEREST
The authors declare no conflict of interest.
 Meng H, Gong J, Fang L, Song Z, Wu F, Zhou B, et al. Effect of
interferon-y on NF-[kappa]B and cytokine IL-18 and IL-27 in acute
pancreatitis. Bosn J Basic Med Sci 2013; 13 (2): 114-118.
 Hayashi T, Ishida Y, Kimura A, Iwakura Y, Mukaida N, Kondo T.
IFN-[gamma] protects cerulein-induced acute pancreatitis by repressing
NF-[kappa]B activation. The Journal of Immunology 2007; 178: 73857394.
 Rau BM, Kruger CM, Hasel C, Oliveira V, Rubie C, Beger HG, et
al. Effects of immunosuppressive and immunostimulative treatment on
pancreatic injury and mortality in severe acute experimental
pancreatitis. Pancreas 2006; 33 (2): 174-183.
 Kilic E, Amanvermez R, Kefeli M, Polat C, Gunay M. Protective
effects of etanercept and methylprednisolone on pancreatic damage in
cerulein-induced acute pancreatitis. Saudi Med J 2010; 31 (4): 394-399.
 Brunicardi FC, Anderson DK, Billiar TR, Dunn DL, Hunter JG,
Matthews JB, et al. Schwartz's principles of surgery (9th ed.),
2010. Chapter 33: Pancreas, pp: 1177-1186.
Ramazan Amanvermez (1) *, Gokhan Selquk Ozbalci (2)
(1) Department of Medical Biochemistry, Faculty of Medicine,
Ondokuz Mayis University 55139 Samsun, Turkey. (2) Department of General
Surgery, Faculty of Medicine, Ondokuz Mayis University 55139 Samsun,
* Corresponding author: Ramazan Amanvermez, Department of Medical
Biochemistry, Faculty of Medicine, Ondokuz Mayis University 55139
Samsun, Turkey Phone: +90 362 3121919, ext.: 2534 Fax: +90 362 4576041