Figure 2.

 Susceptibility to acute pancreatitis (AP). Hypothetical relationship between pancreatitis risk factors and developing episodes of acute pancreatitis. Two subjects are illustrated who have identical environmental exposures but few genetic risk factors (low risk, bottom line) or significant risk factors (high risk, top line). The risk of developing pancreatitis at any point in time is likely variable, and reflects the combination of susceptibility factors and triggering factors that alter risk (for example, meals, alcohol, biliary, etc). Acute pancreatitis develops when the protective mechanisms are no longer adequate and the combined genetic and environmental risk factors and environmental triggers drive the pancreas over the threshold needed to initiate acute pancreatitis (AP threshold, broken line). Note that the subject with the higher underlying risk develops clinically recognised acute pancreatitis after several triggering events whereas the low risk subject does not develop acute pancreatitis with the same events.