Introduction: As natural calcium (Ca) antagonist, magnesium (Mg) seems to counteract Ca-signaling pathways involved in the intracellular protease activation leading to acute pancreatitis. We systematically reviewed the current literature to investigate the role of Mg in the pathogenesis of acute pancreatitis and its possible use in detecting, predicting, and preventing acute pancreatitis.
Methods: A systematic search was performed in PubMed/Scopus/Web of Science to identify in vivo and in vitro studies reporting data on Mg in acute pancreatitis.
Results: Twelve studies were included. Due to their heterogeneity, we conducted a review without the intent of inference. Mg deficiency in pancreatic acinar cells seems to be frequently associated with serum hypocalcemia and acute pancreatitis. Mg seems to contrast intracellular Ca accumulation which induces premature enzyme activation and acute pancreatitis. Several in vivo and in vitro experiments showed beneficial effects of Mg supplementation in counteracting Ca-signaling pathways and subsequent pathological events. Moreover, a recent randomized trial demonstrated the efficacy of Mg supplementation in reducing the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in high-risk patients.
Conclusion: Mg is a natural antagonist of Ca-signaling pathways and, when deficient, predisposes to acute pancreatitis. Mg supplementation may be useful to prevent acute pancreatitis in many contexts, such as post-ERCP or after pancreatic surgery. The heterogeneity of the included studies represents an important limitation that may hinder robust conclusions.
Keywords: Acute pancreatitis; Calcium antagonist; Magnesium.
Magnesium seems to be involved in several important mechanisms in our body. One of these is to counteract calcium in the process that causes the activation of the acute inflammation of the pancreas, so-called acute pancreatitis. We conducted a systematic review of the current literature to better investigate the role of magnesium in acute pancreatitis and its possible use in detecting, predicting, and preventing it. We found that 11 studies were focused on this topic. These studies showed that when magnesium is deficient in the pancreas, patients more frequently have reduced serum calcium and its accumulation in the pancreatic cells. These conditions predispose to acute pancreatitis. Moreover, in vivo and in vitro experimental studies showed beneficial effects when magnesium was supplemented. Accordingly, magnesium may be useful to prevent acute pancreatitis in many clinical situations, such as after pancreatic surgery. However, the included studies were very heterogeneous, and this may hinder further solid conclusions.
© 2024 The Author(s). Published by S. Karger AG, Basel.