Pancreas autolysis

The pancreatic juice is released through the ampulla of Vater into the duodenum to aid in the digestive process as well as buffer acidic fluid released from the stomach (Fig. 20-1). The pancreas contains a trypsin inhibitor to prevent autolysis. 

Autolysis of the pancreas can occur when zymogens are activated in the pancreas before being released into the duodenum. Acute pancreatitis can result from the initial injury to the zymogen-producing cells, which is followed by neutrophil invasion of the pancreas, and that ends in further activation of enzymes within the pancreas. This cascade of events can be destructive to the pancreas and harmful to the patient. 

Pancreatic enzymes a group of at least 12 digestive enzymes, including some of the most investigated of all enzymes Autolysis of the pancreas does not occur, because the proteolytic enzymes, trypsin, chymo-trypsin A and B, elastase and carboxypeptidase A and B, and phospholipase A2 are synthesized and stored in the pancreas as inactive zymogens. The other P. e. require effectors for optimal activity, which are present in the duodenum. Trypsin inhibitors in the pancreatic tissue and secretion afford additional protection against proteolytic destruction by active P.e. With the exception of cholesterol esterase (M, 400,000), the M, of P.e. lie between 13,700 (ribonu-clease) and 50,000 (a-amylase). 

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