Title: The role of apheresis and insulin therapy in hypertriglyceridemic acute pancreatitis - a
concise review
Version: 1 Date: 23 Jul 2023
Reviewer:  Ulrich Julius
Reviewer's report:
This review summarizes the current knowledge about HTG-induced acute pancreatitis both with
respect to pathophysiology and to therapy. The current literature is very well taken into account.
The reviewer agrees with the conclusions drawn by the author.
There remains one open question: does the author believe that the removal of cytokines or
of C-reactive protein which are described for apheresis therapy plays a role with respect to
the effectiveness of this extracorporeal treatment in patients with severe acute hyperlipidemic
pancreatitis? Any data available?
Minor comments
Introduction: “lipid apheresis” should be replaced by lipoprotein apheresis (lipoproteins are
removed, no delipidation takes place)
Pathogenesis: “10 mmol/L (approx. equal to 1000 mg/dL)” – 10 mmol/L equals to 882 mg/dL
Conservative treatment: “Heparin releases endothelial lipase, which has only a transient effect
and later actually reduces lipolytic activity” – it is not understandable how endothelial lipase
reduces lipolytic activity – this sentence should be rewritten.
The authors should describe how the insulin is given as an infusion – in the glucose solution or
separately with the help of an infusion machine.
Improvement: “retrospective comparison of DFPF” – correct DFPP
Title: The role of apheresis and insulin therapy in hypertriglyceridemic acute pancreatitis - a
concise review
Version: 1 Date: 23 Jul 2023
Reviewer:  Ulrich Julius
Reviewer's report:
This review summarizes the current knowledge about HTG-induced acute pancreatitis both with
respect to pathophysiology and to therapy. The current literature is very well taken into account.
The reviewer agrees with the conclusions drawn by the author.
There remains one open question: does the author believe that the removal of cytokines or
of C-reactive protein which are described for apheresis therapy plays a role with respect to
the effectiveness of this extracorporeal treatment in patients with severe acute hyperlipidemic
pancreatitis? Any data available?
Minor comments
Introduction: “lipid apheresis” should be replaced by lipoprotein apheresis (lipoproteins are
removed, no delipidation takes place)
Pathogenesis: “10 mmol/L (approx. equal to 1000 mg/dL)” – 10 mmol/L equals to 882 mg/dL
Conservative treatment: “Heparin releases endothelial lipase, which has only a transient effect
and later actually reduces lipolytic activity” – it is not understandable how endothelial lipase
reduces lipolytic activity – this sentence should be rewritten.
The authors should describe how the insulin is given as an infusion – in the glucose solution or
separately with the help of an infusion machine.
Improvement: “retrospective comparison of DFPF” – correct DFPP
Please review this paper.
user
Title: The role of apheresis and insulin therapy in hypertriglyceridemic acute pancreatitis - a
concise review
Version: 1 Date: 23 Jul 2023
Reviewer:  Ulrich Julius
Reviewer's report:
This review summarizes the current knowledge about HTG-induced acute pancreatitis both with
respect to pathophysiology and to therapy. The current literature is very well taken into account.
The reviewer agrees with the conclusions drawn by the author.
There remains one open question: does the author believe that the removal of cytokines or
of C-reactive protein which are described for apheresis therapy plays a role with respect to
the effectiveness of this extracorporeal treatment in patients with severe acute hyperlipidemic
pancreatitis? Any data available?
Minor comments
Introduction: “lipid apheresis” should be replaced by lipoprotein apheresis (lipoproteins are
removed, no delipidation takes place)
Pathogenesis: “10 mmol/L (approx. equal to 1000 mg/dL)” – 10 mmol/L equals to 882 mg/dL
Conservative treatment: “Heparin releases endothelial lipase, which has only a transient effect
and later actually reduces lipolytic activity” – it is not understandable how endothelial lipase
reduces lipolytic activity – this sentence should be rewritten.
The authors should describe how the insulin is given as an infusion – in the glucose solution or
separately with the help of an infusion machine.
Improvement: “retrospective comparison of DFPF” – correct DFPP
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