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Eosinophils in the pathogenesis of pancreatic disorders

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Abstract

Eosinophils comprise approximately 1–4% of total blood leukocytes that reside in the intestine, bone marrow, mammary gland, and adipose tissues to maintain innate immunity in healthy individuals. Eosinophils have four toxic granules known as major basic protein (MBP), eosinophil cationic protein (ECP), eosinophil peroxidase (EPO), and eosinophil-derived neurotoxin (EDN), and upon degranulation, these granules promote pathogenesis of inflammatory diseases like allergy, asthma, dermatitis, and gastrointestinal disorders. Additionally, the role of eosinophils is underscored in exocrine disorders including pancreatitis. Chronic pancreatitis (CP) is an inflammatory disorder that occurs due to the alcohol consumption, blockage of the pancreatic duct, and trypsinogen mutation. Eosinophil levels are detected in higher numbers in both CP and pancreatic cancer patients compared with healthy individuals. The mechanistic understanding of chronic inflammation–induced pancreatic malignancy has not yet been reached and requires further exploration. This review provides a comprehensive summary of the epidemiology, pathophysiology, evaluation, and management of eosinophil-associated pancreatic disorders and further summarizes current evidence regarding risk factors, pathophysiology, clinical features, diagnostic evaluation, treatment, and prognosis of eosinophilic pancreatitis (EP) and pancreatic cancer.

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Acknowledgements

We thank Gulshan Singh and Loula Burton from the Department of Global Environmental Health Sciences and Office of Research Proposal Development, Tulane University for helping with figure preparation and manuscript editing, respectively.

Funding

The authors acknowledge partial financial support of NIH grant R01 AI080581 (AM).

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Authors and Affiliations

  1. School of Medicine, Gastrointestinal and Hepatology Division, Stanford University, Stanford, CA, 94304, USA

    Murli Manohar

  2. John W. Deming Department of Medicine, Section of Pulmonary Diseases, Tulane Eosinophilic Disorder Center (TEDC), Tulane University School of Medicine, New Orleans, LA, 70112, USA

    Hemanth Kumar Kandikattu, Sathisha Upparahalli Venkateshaiah, Chandra Sekhar Yadavalli & Anil Mishra

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  1. Murli Manohar
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Correspondence to Anil Mishra.

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This article is a contribution to the Special issue on: Eosinophils - Guest Editor: Hans-Uwe Simon

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Manohar, M., Kandikattu, H.K., Upparahalli Venkateshaiah, S. et al. Eosinophils in the pathogenesis of pancreatic disorders. Semin Immunopathol 43, 411–422 (2021). https://doi.org/10.1007/s00281-021-00853-0

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