The acute phase reaction of the exocrine pancreas. Gene expression and synthesis of pancreatitis-associated proteins.

In different tissues alteration of protein synthesis has been observed during acute stress. In this review we characterise the modulation of pancreatic protein synthesis during inflammation. A sustained decrease of mRNA levels of secretory enzymes is accompanied by noncoordinated alterations of protein synthesis during the acute phase and the recovery from pancreatitis. For that regulation both translational and transcriptional alterations are of importance. The most prominent finding was the expression of pancreatitis-associated proteins (PAP) in humans or rats, which are absent in the normal gland but synthesised during acute pancreatitis. PAPs are pancreatic secretory proteins, their mRNA were cloned and sequenced and the sequence of encoded preproteins of 175 amino acids were deduced. The PAP expression increased as a function of the severity of pancreatitis. It can be assayed in serum and may be used as a marker of the disease. Due to its affinity to bacterial surfaces the PAP molecule could act as an endogenous antibiotic factor that prevents the bacterial infection of the inflamed pancreas.