Koligo Therapeutics refers to its islet product solution as Kyslecel.

Transformative cell therapies for pancreatic disease.

CHRONIC PANCREATITIS

“Chronic pancreatitis (CP) is inflammation of the pancreas that does not heal or improve—it gets worse over time and leads to permanent damage. Chronic pancreatitis eventually impairs a patient’s ability to digest food and make pancreatic hormones. Chronic pancreatitis often develops in patients between the ages of 30 and 40 and is more common in men than women.” ––National Pancreas Foundation

Chronic Pancreatitis can lead to a number of secondary complications, some of which are serious if not treated appropriately such as increasing pain, deteriorating quality of life and over time, progress to diabetes as islet cells, the cells responsible for producing insulin and controlling blood glucose levels, lose viability due to increasing tissue dysfunction

  • Long-term CP prognosis is Type 3c Diabetes: 50% become T3cD at 10yrs, 80% at 25 yrs
  • 80-94% of CP patients experience decrease QoL due to debilitating pain
  • Up to 80% of CP patients resort to high doses of opioids with ~20% becoming addicted

CURRENT OPTIONS FOR PATIENTS WITH CHRONIC PANCREATITIS

Current options for the inflammation or fibrosis associated with pancreatitis remain limited. Management and treatment strategies range from pain medications to major surgical procedures.

Chronic Pancreatitis Pain Medications
Significant pain associated with chronic pancreatitis can seriously reduce a patient’s quality of life. It is important to treat chronic pancreatitis as soon as it is diagnosed because repeated episodes of inflammation can cause irreversible damage, and pain relief becomes much less effective. Pain relief can be achieved with medication, often using the World Health Organization’s 3-step ladder approach to pain relief:

  1. Pain medication begins with nonopioids (like acetaminophen, ibuprofen, or both).
  2. If nonopioids do not relieve pain, mild opioids (like codeine) are given.
  3. If mild opioids do not relieve pain, strong opioids (like morphine) are given.

Chronic Pancreatitis Antioxidant Therapies
Clinical evidence suggests that acute pancreatitis (AP) and chronic pancreatitis (CP) development can be associated with oxidative stress. Free radical activity and oxidative stress indices are elevated in the blood and duodenal fluid of patients with pancreatitis. Based on these findings, some physicians use antioxidant regimens in combination with traditional pancreatitis therapy. However, the overall effectiveness of antioxidants is not well established, and the optimal dosage is unclear.

Chronic Pancreatitis Surgical Procedures
When medical therapy fails to provide relief to patients with chronic pancreatitis, surgical therapy may be an option. Conventional pancreatic operations aim to relieve pain by correcting an anatomical or morphological problem such as a blocked duct, poor drainage or an inflammatory mass in the head of the pancreas.

CHRONIC PANCREATITIS SURGICAL OPTIONS:

Whipple Procedure for Chronic Pancreatitis
A pancreaticoduodenectomy, or Whipple procedure, is a substantial operation intended to remove the gall bladder, bile duct, duodenum (initial portion of the small intestine), as well as the head of the pancreas. The remaining organs are then joined to reestablish the gastrointestinal tract and enable proper food digestion.

Distal Pancreatectomy for Chronic Pancreatitis
Rather than remove the head of the pancreas during surgery, as is done in a Whipple procedure, a distal pancreatectomy involves removal of the tail of your pancreas.

Puestow Procedure for Chronic Pancreatitis
Indicated for symptomatic chronic pancreatitis patients with pancreatic ductal obstruction and a dilated main pancreatic duct. This operation involves creating a longitudinal incision along the pancreas while the main pancreatic duct is filleted open longitudinally from the head of the organ to its tail. The duct and pancreas are then attached to a loop of the small intestine which is oversewn to the exposed pancreatic duct to allow its drainage. When successful, meaningful pain relief can be achieved for a period of time.

Total Pancreatectomy with Islet Autologous Transplantation (TP-IAT)
The only cure for CP is total pancreatectomy (TP). However, TP raises other risks including diabetes, mellitus, exocrine insufficiency, and the risks associated with a major surgery. Islet auto-transplant (IAT) after TP can mitigate some of these risks. Koligo’s experience with TP-IAT indicates that increasing numbers of patients will benefit from TP-IAT and achieve long-term pain relief from CP, increased quality of life, and a good chance for insulin independence. It is important to note that a significant factor weighing on the election for TP-IAT is that removal of the pancreas, ensures the patient will require pancreatic enzyme replacement therapy (PERT) for life.

MORE INFORMATION ABOUT CHRONIC PANCREATITIS

There are a number of excellent resources to learn more about chronic pancreatitis and related complications, the risks and benefits of various treatments: