Role of Natural Antioxidant in the Management of Chronic Pancreatitis

ABSTRACT Background: Chronic pancreatitis (CP) is a progressive inflammatory disease of the pancreas that involves irreversible structural destruction, fibrosis, and functional dysfunction. There is mounting evidence to indicate that oxidative stress is a major contributor to the pathogenesis and progression of CP since it enhances persistent inflammation, acinar cell injury, and pancreatic fibrosis. Affected endogenous antioxidant defence systems only increase the degree of oxidative damage, which contributes to the development of disease and chronic pain. Objective: The purpose of the review is to critically assess the importance of natural antioxidants in the management of chronic pancreatitis with a particular emphasis on mechanistic understanding, experimental literature, and more recent clinical results. Methods: A thorough literature search on PubMed, Google scholar, and Scopus databases was carried out on studies published in 2020-25. They included preclinical studies, clinical trials, systematic reviews and meta-analyses assessing the effects of oxidative stress, antioxidant status and antioxidant-based interventions on chronic pancreatitis. Results: The experimental studies show a consistent decrease in the generation of reactive oxygen species, inhibition of redox-sensitive inflammatory signaling by natural antioxidants, and prevention of pancreatic fibrosis with signaling pathway regulation of nuclear factor erythroid 2-related factor 2 (Nrf2) and nuclear factor-kB (NF-kB). There is clinical evidence that antioxidant supplementation enhances antioxidant status and could decrease the severity of pain and oxidative stress indicators in the chosen CP patients. The most consistent benefits are observed with combination antioxidant therapy and micronutrient supplementation, yet clinical outcomes are still inconsistent because studies have heterogeneity with respect to study designs and patient populations. Conclusion: Natural antioxidants offer a prospective adjunctive treatment in the treatment of chronic pancreatitis through the action of oxidative stress and inflammation. Although there is current evidence to suggest their potential benefits, more large-scale, adequately designed, clinical trials using standard formulations and individualized treatment regimens are needed to determine their ultimate place in standard clinical procedures. Keywords: Chronic pancreatitis; Oxidative stress; Natural antioxidants; Inflammation; Fibrosis; Nutraceuticals