Figure 3

The yin and yang of autophagy in acute pancreatitis. On one hand, VMP1-Beclin1 complex-mediated zymophagy, a selective autophagy, prevents pancreatic acinar cell death through degradation of zymogen. On the other hand, deficiency of LAMP2, Gnptab and SPINK1 cause impaired autophagy flux and increased autophagosome accumulation, which mediates vacuole formation in pancreatic acinar cells, intracellular activation of trypsinogen, cell death and the inflammatory response. By contrast, deficiency of ATG5 decreases autophagosome formation, which reduces intracellular activation of trypsinogen and pancreatic damage in AP. Thus, autophagy plays a dual role in the regulation of AP.