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Trypsin isnt the only culprit : Surprisingly, animal studies show that pancreatitis can be induced even in animals that dont produce trypsinogen (or trypsin).[ref] One study explains: NF-B activation that happens parallel and independent to trypsinogen activation can still drive the development of the acute or chronic pancreatitis even in absence of trypsin.[ref] This has led researchers to believe that pancreatitis can also be driven by multiple factors, including the translocation of gut bacteria, viruses, or fungi into the pancreas .[ref] In addition, a recent study showed that cell death in the acinar cells is caused by endoplasmic reticulum stress and can be independent of trypsinogen activation