A special issue titled “Novel Therapeutic Strategies for Pancreatitis” published in Hepatobiliary & Pancreatic Diseases International(August 2025) presents a comprehensive overview of groundbreaking approaches for managing pancreatitis, a major global health burden.
Guest-edited by Professors Li Zhaoshen and Zou Wenbin from Changhai Hospital, Naval Medical University, the issue synthesizes the latest advances in mechanism-driven therapies, regenerative medicine, and precision interventions that are reshaping the clinical management of acute, chronic, and autoimmune pancreatitis.
Evolution of Acute Pancreatitis Management
The editorial highlights a paradigm shift from supportive care to targeted interventions for acute pancreatitis (AP). Recent controlled trials demonstrate that moderate fluid resuscitation outperforms aggressive hydration, while low-molecular-weight heparin reduces necrosis and inflammation.
Emerging regenerative approaches include hypoxia-preconditioned mesenchymal stem cells that deliver functional mitochondria to restore cellular energy metabolism and repair acinar damage. Molecular therapies targeting calcium signaling, such as ORAI1 channel inhibitors, represent promising early-stage candidates.
Innovative Strategies for Chronic Pancreatitis
For chronic pancreatitis (CP), the issue describes several innovative approaches. “Chemical pancreatectomy” enables targeted tissue ablation while preserving endocrine function, and AAV8-mediated SPINK1 gene therapy has shown potential in reversing fibrosis in animal models.
Endoscopic retrograde cholangiopancreatography combined with extracorporeal shock wave lithotripsy remains crucial for pancreatic stone removal, with pre-procedural indomethacin effectively preventing post-ERCP pancreatitis.
Advances in Autoimmune Pancreatitis Treatment
Corticosteroids continue as first-line treatment for autoimmune pancreatitis (AIP), with immunosuppressants, biologics like rituximab, and TNF inhibitors reserved for refractory cases. Single-cell transcriptomic studies have identified novel fibrosis-related targets such as the HIF-1α-visfatin axis, opening avenues for immunomodulatory therapies tailored to AIP subtypes.
Future Directions and Clinical Implementation
The editorial emphasizes that the future of pancreatitis management lies in precision, integration, and innovation. Combining molecular targeting, regenerative medicine, and immunomodulation may revolutionize care for millions worldwide.
The translation of stem cell and gene therapies offers potential not only for symptom relief but also for preventing progression from acute to chronic disease stages.
Multidisciplinary Collaboration and Precision Gastroenterology
Enhanced collaboration among gastroenterologists, surgeons, geneticists, and immunologists is establishing precision gastroenterology as a cornerstone of pancreatitis treatment.
This integrated approach promises improved long-term outcomes and new hope for patients through personalized therapeutic strategies based on individual disease mechanisms and characteristics.
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