摘要:

IntroductionIn autoimmune diseases, malignancies, and inflammatory conditions, a correlation of serum levels of CD44, interleukin-2 receptor (IL-2r), and neopterin with disease activity could be shown.AimsTo assess the immune parameters in chronic pancreatitis in correlation to clinical data to evaluate the potential role of immune dysfunction as a risk factor.MethodologyLevels of IL-2r, sCD44, sCD44v6, and neopterin were measured using the enzyme-linked immunosorbent assay in 63 patients with chronic pancreatitis who underwent surgery between 1992 and 1995 in our institution. Clinical data were evaluated prospectively before surgery, and a follow-up investigation was conducted in 1997.ResultsMean serum levels of CD44, CD44v6, and neopterin were significantly lower in patients with chronic pancreatitis compared with the control group. The mean level of IL-2r was also lower in chronic pancreatitis, but this difference was not significant. However, no influence of immunosuppressive factors such as alcohol consumption, cigarette smoking, or diabetes could be detected on the levels of IL-2r, CD44, CD44v6, and neopterin.ConclusionIn accordance with other diseases of reduced immunoreactivity, depressed serum levels of biomarkers in chronic pancreatitis are caused by reduced T-lymphocyte and macrophage activation. By ruling out a significant influence of concomitant immunosuppressive factors, we conclude that the inflammatory process itself is the source of the depressed immune function, which might be restored by surgical resection.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

IntroductionIn acute pancreatitis, nonesterified fatty acids (NEFA) might be released by lipase and cause tissue necrosis by their detergent properties, but this has not been established in vivo.AimsTo measure the release of NEFA in the blood stream, pancreatic tissue, and peritoneal cavity during taurocholate-induced acute necrotizing pancreatitis in rats.MethodologyAscites and blood were repeatedly sampled; after 24 hours, pancreatic lesions were scored, and NEFA were measured in the pancreas. The effects of a specific lipase inhibitor (Tetrahydrolipstatin [THL]) were also studied.ResultsA slight transient increase (22%) of NEFA concentration was observed in systemic circulation but did not parallel the time course of lipase activity, arguing against an intravascular production of NEFA by circulating lipase. Pancreatic NEFA did not differ between rats with pancreatitis and control rats. NEFA in ascites increased to threefold the basal value immediately after taurocholate and decreased rapidly thereafter, whereas lipase increased later in ascites and remained elevated during the 24-hour duration of the experiment. Lipase inhibition by THL neither modified the early increase of NEFA in ascites, nor altered the macroscopic, enzymatic, and histologic evolution of pancreatitis.ConclusionThis in vivo study does not confirm the hypothetical role of NEFA produced by pancreatic lipase in the necrotic process and its systemic complications, up to now mainly suggested on the basis of ex vivo experiments.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

IntroductionEndoscopic retrograde cholangiopancreatography (ERCP) is a well-established method in diagnosis and management of biliary and pancreatic diseases. The procedure carries the risk of serious complications; the most common is pancreatitis. The severity of ERCP-related pancreatitis largely depends on the inflammatory response to the procedure.AimsThe aim of our study was to evaluate the inflammatory response after diagnostic and therapeutic ERCP based on monitoring of plasma concentration of the following substances: amylase, lipase, white blood cells, interleukin 6 (IL-6), C-reactive protein (CRP), hydrogen peroxide, malonylodialdehyde (MDA), and conjugated dienes (CD).MethodologyThe study was performed on 40 patients who were divided into two groups according to the procedure performed: Group1–28 patients after ERCP with endoscopic sphincterotomy (ES) and Group 2–12 patients after diagnostic ERCP. The parameters were measured before ERCP and 2, 24, and 48 hours after the procedure.ResultsAfter diagnostic and therapeutic ERCP, the increase in plasma concentration of amylase, lipase, IL-6, and CRP were observed. Acute pancreatitis developed in three of the patients from group 1. The increase in lipase and CRP concentration was significantly higher after therapeutic ERCP with ES than after the diagnostic procedure. Asymptomatic hyperamylasemia and hyperlipasemia occurred more often after therapeutic than diagnostic ERCP. A positive correlation between the increase of IL-6 and CRP concentration was found. After uncomplicated diagnostic or therapeutic ERCP, no increase of reactive oxygen species and lipid peroxidation products was observed.ConclusionDiagnostic ERCP stimulates a systemic inflammatory response, the intensity of which is magnified after ES. After uncomplicated ERCP, the balance between oxidative and anti-oxidative mechanisms is retained.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

AimsTo ascertain whether analysis of K-rasmutations at codon 12 (KRM) in the supernatant of pure pancreatic juice (PPJ) is more useful for the diagnosis of pancreatic carcinoma (PCa) than that in sediment, the authors analyzed KRM in DNA extract from not only the sediment but also the supernatant of PPJ and compared the results.MethodologyPPJ was collected endoscopically from 19 patients with PCa and 25 patients with chronic pancreatitis (CP). DNA was extracted from the supernatant and the sediment of PPJ. Mutant allele-specific amplification (MASA) was performed for KRM analysis with the DNA extracts from these samples.ResultsThe incidence of KRM in the supernatant of PPJ was 89% (17 of 19) in patients with PCa and 28% (7 of 25) in patients with CP, whereas that in the sediment was 79% (15 of 19) in patients with PCa and 20% (5 of 25) in patients with CP. Although there was no significant difference in KRM incidence between supernatant and sediment, the positive rate of KRM was higher in the former. Additionally, with regard to the PCa cases, KRM were found in the supernatant alone in four cases and in the sediment alone in two cases. Consequently, by a combination assay, all of the patients with PCa showed KRM in either the supernatant or sediment of PPJ. Although there was no relation between the incidence of KRM in PPJ and the location and size of tumor, and clinical stage of carcinoma in the patients with PCa, two patients with clinical stage I disease showed KRM in the supernatant.ConclusionThese results suggest that the positive rate of KRM in the supernatant is not lower than that in the sediment, and simultaneous analysis of KRM in the supernatant and sediment of PPJ enhances the genetic diagnosis of PCa.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

IntroductionIn the general population, cholecystectomy, diabetes, and chronic pancreatitis seem to be associated with an increased risk of developing pancreatic cancer.AimsWe assessed whether previous cholecystectomy, gastrectomy, or diabetes mellitus may be risk factors for pancreatic cancer in patients with chronic pancreatitis.MethodologyWe analyzed 853 patients with chronic pancreatitis (110 women, 743 men) with a median follow-up period of 14 years with particular reference to establishing which patients had previously undergone cholecystectomy or distal gastric resection (Billroth II anastomosis) or had diabetes or gallstone disease and the respective time scales involved.ResultsPancreatic cancer developed in 17 patients with chronic pancreatitis after a median period of 8 years from onset of pancreatitis symptoms (range, 3–38 years). Excluding two cholecystectomies performed 1 year before diagnosis of cancer, cholecystectomy was performed in 7/17 (41%) patients with pancreatic cancer and in 381/836 (46%) of the other patients with chronic pancreatitis. Forty-nine (10%) patients with chronic pancreatitis and no pancreatic cancer had undergone cholecystectomy during the years before the onset of chronic pancreatitis, whereas none of the patients in whom a pancreatic malignancy developed had undergone cholecystectomy before the onset of chronic pancreatitis symptoms. Gastrectomies were performed in 116 patients (14%), 47 before the onset of chronic pancreatitis. Only 2/17 patients with pancreatic cancer had undergone previous gastrectomy, though in both cases only shortly before diagnosis of the cancer. Diabetes was diagnosed in 353 patients, but only in 30 (4%) before onset of chronic pancreatitis. Only 1/17 patients (6%) with pancreatic cancer had long-standing diabetes, whereas diabetes developed in 3/17 shortly before diagnosis of pancreatic cancer.ConclusionsCholecystectomy, gastrectomy, and diabetes are not major risk factors for the development of pancreatic cancer in patients with chronic pancreatitis.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

IntroductionThe peptide hormone cholecystokinin (CCK) plays an important role in the gastrointestinal tract. The rat pancreatic CCK receptor is a highly glycosylated membrane receptor that is able to bind to plant lectins such as wheat germ agglutinin (WGA) andUlex europaeusagglutinin (UEA-I).Aims and MethodologyWe used both lectins to block this receptor for studying the pathophysiologic relevance of its oligosaccharide side chains. In the present study we investigated the influence of WGA and UEA-I on CCK-8–induced &agr;-amylase secretion of the rat pancreatic tumor cell line AR42J, which expresses both CCK-A and CCK-B receptors.ResultsUnder the influence of WGA (25 &mgr;g/mL), the &agr;-amylase release was reduced by 25% after 30 minutes compared with the hormone-stimulated controls. UEA-I (25 &mgr;g/mL) caused a reduction of 20%. The simultaneous application of the lectins with CCK antagonists L 364,718 or L 365,260 led to a reduction of secretion, but the assignment to CCK-A or CCK-B receptors was not possible.ConclusionIn long-term studies, both lectins revealed no toxic or apoptosis-inducing effects. On the contrary, WGA showed an inhibitory effect on cell proliferation and led to improved differentiation of cells.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

IntroductionAlthough the subcutaneous tissue is considered as an attractive site for pancreatic islet transplantation, the success rate has been extremely low.AimsTo use basic fibroblast growth factor (bFGF) to induce neovascularization and sufficient blood flow around the space formed for grafted islets in the subcutaneous tissue to improve the islet survival.MethodologyIn the experimental group, two bFGF-releasing devices were implanted bilaterally into the subcutaneous tissue (back) of diabetic Lewis rats. One week after implantation, in the same site, isolated rat islets were syngeneically transplanted after the removal of the devices. In the control group, two devices without bFGF were implanted before subcutaneous islet transplantation of the same number of islets.ResultsOne week after the implantation of the bFGF-releasing devices in the experimental animals, the devices induced angiogenesis by slow release of bFGF. After transplantation of islets, the neovascularized recipient rats showed significant decreases in nonfasting blood glucose concentration and maintained normoglycemia for more than 3 months. However, in the control group, all rats failed to achieve normoglycemia after transplantation in the absence of neovascularization.ConclusionThis study provides evidence that the subcutaneous tissue is a promising site for pancreatic islet transplantation, which suggests the acceptability of this treatment for diabetic recipients.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

AimsTo confirm whether rat islets stored at a temperature just above the freezing point using University of Wisconsin (UW) solution would remain viable for the short term.MethodologyRat islets were stored for 24 hours in UW solution, either at 4°C or at −0.6°C (just above the specific freezing point of the UW solution). After cold storage, the islets were assessed for in vitro viability by static incubation and for in vivo viability by a transplantation study. One thousand islets preserved under different conditions were injected intraportally into a streptozotocin-induced diabetic rat as an isograft. Four weeks after the transplantation, an intravenous glucose tolerance test was performed.ResultsIslets stored at −0.6°C showed higher insulin secretion rates than those stored at 4°C on a static challenge. The interval from transplantation to the achievement of normoglycemia was also shorter in the −0.6°C group than in the 4°C group. After islet transplantation, the daily nonfasting plasma glucose concentration was higher in the 4°C group than in the −0.6°C group. When compared with the 4°C group, the −0.6°C group showed lower blood glucose values during all investigational periods on an intravenous glucose tolerance test.ConclusionIslet preservation at −0.6°C using UW solution is more advantageous for short term.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

AimsTo evaluate the role of nitric oxide (NO) in the coordination of the Ca2+signals generating pulsatile insulin release in pancreatic &bgr; cells isolated fromob/obmice.MethodologyUsing ratiometric fura-2 technique for recording glucose-induced cytoplasmic Ca2+transients, it was possible to demonstrate a synchronization of &bgr; cells lacking contact.ResultsThe frequency of the transients increased 10-fold in the presence of 20 nMglucagon. Additional increase in frequency with maintenance of synchronization was observed when the &bgr; cells were exposed to 100 &mgr;Mof the NO donors sodium nitroprusside and hydroxylamine. Bolus additions of 0.1–10 &mgr;Mgaseous NO resulted in prompt appearance of cytoplasmic Ca2+transients. An activator of soluble guanylate cyclase (mesoporphyrin) increased the frequency of the transients, and inhibition of this enzyme with 1H-(1,2,4) oxadiazolo [4,3-a] quinoxalin-1-one had the opposite effect.ConclusionThe results support the idea that nitrergic nerves generate &bgr;-cell transients of Ca2+synchronizing the activity of the numerous islets in the pancreas.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

IntroductionRecently, results of the clinical application of the two-layer method have shown the morphologic quality of the human pancreas grafts after reperfusion to be excellent, although ischemia-reperfusion injury is related to early graft loss in pancreas transplantation. However, some reports have indicated that heat shock proteins (HSPs) have important functions in response to the stress-related events.AimTo examine whether the two-layer method reduced ischemia-reperfusion injury in a canine pancreas autotransplantation model by investigating the expression of HSPs.MethodologyThere were three experimental groups in which dogs received segmental autografts after preservation by the two-layer method using University of Wisconsin solution (UW) (group 1), simple storage in UW (group 2) for 24 hours, or no preservation (group 3).ResultsIn group 1, pancreatic tissue perfusions were high, and pancreatic exocrine functions were well preserved after 1, 2, and 4 hours of reperfusion with low incidence of graft pancreatitis or vessel thrombosis compared with that in group 2. Moreover, ATP rapidly recovered, and HSP 60 was strongly enhanced after reperfusion in group 1. On the other hand, ATP recovery and the enhancement of HSP 60 were weak after reperfusion in group 2.ConclusionThe two-layer method reduced ischemia-reperfusion injury compared with UW simple storage in canine pancreas autotransplantation with a strong expression of HSP 60.

ISSN:0885-3177    

出版商:OVID    

年代:2001

数据来源: OVID