Reducing Pancreatic Fibrosis Using Antioxidant Therapy Targeting Nrf2 Antioxidant Pathway: A Possible Treatment for Chronic Pancreatitis

Pancreas. 2019 Nov/Dec;48(10):1259-1262. doi: 10.1097/MPA.0000000000001433.

Abstract

Chronic pancreatitis is the progressive inflammation of the pancreas resulting in the irreversible damage of pancreatic structure and function by means of fibrosis. Chronic pancreatitis is most commonly caused by alcohol consumption, although the direct molecular etiology is unknown. Recent studies suggest oxidative stress as a catalyst for pancreatic stellate cell activation leading to the deposition of collagenous extracellular matrix causing pancreatic fibrosis. We review the effect of oxidative stress on pancreatic fibrogenesis and indicate the molecular pathways involved in preventing oxidant-related cell damage. Likewise, we summarize existing antioxidative therapies for chronic pancreatitis and discuss a novel nuclear factor erythroid 2-related factor 2 activator, dimethyl fumarate, and its potential to reduce fibrogenesis by downregulating pancreatic stellate cell activation.

Publication types

  • Review

MeSH terms

  • Animals
  • Antioxidants / therapeutic use*
  • Fibrosis
  • Humans
  • NF-E2-Related Factor 2 / physiology*
  • Oxidative Stress
  • Pancreas / drug effects
  • Pancreas / pathology*
  • Pancreatitis, Chronic / drug therapy*
  • Pancreatitis, Chronic / metabolism
  • Response Elements / physiology

Substances

  • Antioxidants
  • NF-E2-Related Factor 2
  • NFE2L2 protein, human