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Despite the common morphological hallmarks and shared triggers, it has become clear that the signaling pathways might differ
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The proposed mechanisms include upregulation of beta-3 adrenergic receptors in adipose tissue, activation of the cAMP-PKA lipolytic cascade through enhanced catecholamine sensitivity, direct or indirect inhibition of acetyl-CoA carboxylase (ACC) reducing de novo lipogenesis by approximately 43-57% in vitro, and activation of hormone-sensitive lipase (HSL) with increased glycerol release
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157 For example, a European multicenter study involving 424 patients with AP used gene set enrichment analysis to identify enhanced short-chain fatty acid production pathways in the oral microbiome of patients with severe disease, suggesting potential novel biomarkers and therapeutic targets
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