Bentiromide

A multicenter Japanese study of 624 type 1 autoimmune pancreatitis patients examined risk factors for pancreatic stone formation, which occurred in 5% of patients. The bentiromide test value at diagnosis was significantly lower in stone-forming patients (48.6%) than in non-stone-forming patients (60.5%), indicating more severe exocrine dysfunction. Stone formation was also associated with higher hemoglobin A1c after corticosteroid treatment, pancreatic atrophy, hilar/intrahepatic bile duct stenosis, and pancreatic head swelling. Multivariate analysis confirmed pancreatic atrophy, hilar/intrahepatic bile duct stenosis, pancreatic head swelling, and longer follow-up as independent risk factors. Pancreatic head swelling likely causes juice stasis, leading to stone development and progressive pancreatic dysfunction over time.

Fig. 1 Clinical features with bentiromide test value at diagnosis. (Ito T.; et al. 2019)

Bentiromide, a drug for assessing pancreatic function, exists as six tautomers. DFT and PCM solvent models showed the most stable tautomer contains three carbonyl groups, with negligible amounts of others in water. NBO analysis explored frontier molecular orbitals. Interaction with a carbon nanotube and a γ-Fe₂O₃ nanoparticle was studied. Intermolecular hydrogen bonds critically influenced energy behavior during interaction with the γ-Fe₂O₃ nanoparticle.