{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T01:57:46Z","timestamp":1793325466847,"version":"4.5.0"},"reference-count":224,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Research Executive Agency under the project training in translational protocols for minimal invasive diagnosis and therapy in pancreatico-biliary cancers\u2014trip","award":["101079210\/2022"],"award-info":[{"award-number":["101079210\/2022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Acute pancreatitis (AP) is among the most frequent gastroenterology emergencies, with hospital admission rates on the rise in recent decades. However, a specific treatment for this condition is still lacking. Mitochondrial damage induced by oxidative stress is regarded as the key event in the pathophysiology and initiation of cellular damage in AP. In the early stages of AP, the oxidant\u2013antioxidant balance changes rapidly, and there are significant data regarding the reduced serum levels of antioxidants, with this event being correlated with the clinical severity of pancreatitis. Therefore, addressing oxidative stress could represent a potential therapeutic target in AP. In this comprehensive review, we aimed to provide an update on current evidence regarding clinical and experimental data on antioxidant use in AP, focusing on human studies investigating the effects of single and combined antioxidant supplementation. Although a multitude of animal studies demonstrated that antioxidant therapy has beneficial effects in experimental AP by reducing oxidative injury, inflammatory markers, and ameliorating histological outcomes, human trials showed predominantly conflicting results, with some studies suggesting benefit while others showed no effect, or even potential harm, when antioxidants were administered in high doses or in combination. Moreover, some antioxidants with beneficial results in experimental settings did not show the same efficacy when translated to human studies, which may be a consequence of either inappropriate dosage, route of administration and duration of therapy, or altered pharmacodynamics in vivo. In conclusion, oxidative stress plays a key role in the pathophysiology of AP by enhancing acinar cell injury, inflammation, and systemic complications. Future studies should be centered on optimized dosing strategies, early administration protocols, targeted patient selection, and delivery methods of proper pharmaceutical forms.<\/jats:p>","DOI":"10.3390\/nu17152390","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T11:44:45Z","timestamp":1753184685000},"page":"2390","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Targeting Oxidative Stress in Acute Pancreatitis: A Critical Review of Antioxidant Strategies"],"prefix":"10.3390","volume":"17","author":[{"given":"Laura Ioana","family":"Coman","sequence":"first","affiliation":[{"name":"Medical Center for Diagnosis, Outpatient Treatment and Preventive Medicine, 011794 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3436-8041","authenticated-orcid":false,"given":"Daniel Vasile","family":"Balaban","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Internal Medicine and Gastroenterology Discipline, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Gastroenterology Department, \u201cDr. Carol Davila\u201d Central Military University Emergency Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan Florin","family":"Dumbrav\u0103","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, \u201cProf. Dr Dimitrie Gerota\u201d Emergency Hospital, 030167 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6084-1974","authenticated-orcid":false,"given":"Horia","family":"P\u0103unescu","sequence":"additional","affiliation":[{"name":"Discipline of Pharmacology, Clinical Pharmacology and Pharmacotherapy, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3182-1683","authenticated-orcid":false,"given":"Ruxandra-Cristina","family":"Marin","sequence":"additional","affiliation":[{"name":"Discipline of Pharmacology, Clinical Pharmacology and Pharmacotherapy, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3678-7584","authenticated-orcid":false,"given":"Mihnea","family":"Costescu","sequence":"additional","affiliation":[{"name":"Discipline of Pharmacology, Clinical Pharmacology and Pharmacotherapy, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4406-9304","authenticated-orcid":false,"given":"Lorena","family":"Dima","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Transilvania University of Brasov, 500017 Brasov, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5826-0815","authenticated-orcid":false,"given":"Mariana","family":"Jinga","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Internal Medicine and Gastroenterology Discipline, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Gastroenterology Department, \u201cDr. Carol Davila\u201d Central Military University Emergency Hospital, 010825 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana Andreia","family":"Coman","sequence":"additional","affiliation":[{"name":"Discipline of Pharmacology, Clinical Pharmacology and Pharmacotherapy, \u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1053\/j.gastro.2021.10.017","article-title":"Burden and Cost of Gastrointestinal, Liver, and Pancreatic Diseases in the United States: Update 2021","volume":"162","author":"Peery","year":"2022","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2669","DOI":"10.1089\/ars.2011.4065","article-title":"The Crucial Role of Early Mitochondrial Injury in L-Lysine-Induced Acute Pancreatitis","volume":"15","author":"Hegyi","year":"2011","journal-title":"Antioxid. 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