Abstract
Background: The role of alcohol (ethanol) in the development of chronic pancreatitis has been intensively investigated. However, ethanol is generally consumed in form of alcoholic beverages which contain numerous non-alcoholic compounds. Up to now in beer more than 2000 and in wine more than 1000 organic and anorganic constituents were defined. Aim: To provide an overview about the effect of different non-alcoholic constituents of alcoholic beverages on the pancreas in comparison to ethanol and to discuss their possible interaction with molecular mechanisms leading to "alcoholic" pancreatitis. Results: The present data indicate that non-alcoholic constituents might be responsible for the stimulatory effect of beer on pancreatic enzyme secretion in humans whereby alcoholic fermentation of glucose might be the essential event generating the stimulatory substances in beer. One of the differentiating characteristics among alcoholic beverages is their polyphenol composition. The first such polyphenols studied were quercetin and rutin followed recently by resveratrol. Both, quercetin and resveratrol have been shown to inhibit pancreatic enzyme output in vitro. Several polyphenols (Resveratrol, catechins, ellagic acid and flavone) have a protective effect against oxidative stress which may play a role in pancreatic injury. Ellagic acid also inhibits in vitro activation of pancreatic stellate cells. A protective effect of resveratrol and catechins on experimental induced acute pancreatitis in rats could also be demonstrated. In addition, different polyphenols (quercetin, rutin, and trans-resveratrol) have an inhibitory effect on pancreatic cancer growth. Conclusions: There is accumulating evidence that natural phenolic compounds of alcoholic beverages exert different effects on the pancreas. Particularly resveratrol protects the pancreas against pro-oxidative activity and inhibits inflammation. In addition, other non-alcoholic constituents of alcoholic beverages exert protective effects in vitro. However, it should be pointed out that alcoholic beverages contain much more non-alcoholic ingredients. The effect of these are still unknown and caution is required in attempting to define alcoholic etiology of pancreatitis without considering the effect of non-alcoholic compounds of alcoholic beverages.
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