胰腺星状细胞在胰腺内外分泌疾病中的作用

胰腺纤维化是胰腺炎、胰腺癌主要的病理学特征。活化的胰腺星状细胞(pancreatic stellate cell,PSC)是胰腺炎致胰腺纤维化的主要效应细胞,在胰腺炎与胰腺癌的纤维化进程中发挥重要作用。近期研究发现,PSC也存在于糖尿病动物胰岛中,可能参与糖尿病胰岛纤维化及β细胞衰竭的发展进程。现就PSC与胰腺炎、胰腺癌及糖尿病关系的研究进展作一综述。     

油红O染色原代未活化胰腺星状细胞脂肪滴的实验观察

目的观察油红O染色原代培养的未活化胰腺星状细胞脂肪滴,并予鉴定。方法选取接种于6孔板中培养4天的原代未活化胰腺星状细胞,予100g/L甲醛液固定,磷酸盐缓冲液漂洗后,加入5g/L油红O饱和液染色,镜下动态观察。胞浆内的脂肪滴一旦着色,即可洗去油红,苏木素衬染胞核,漂洗分化脱色后镜下成像。结果未活化的胰腺星状细胞脂肪滴被油红0染成鲜艳的红色,大小不一的串珠样"油珠子"分散于胞质中,簇集成"环状",呈戒环样包绕在细胞核周围。结论油红染色原代未活化胰星状细胞脂肪滴是鉴定该细胞的重要方法之一。     

白介素-17A在小鼠慢性胰腺炎中的作用研究

目的:研究白细胞介素-17A在小鼠慢性胰腺炎模型中的表达及其对小鼠星状细胞的影响。方法:建立雨蛙肽诱导的小鼠实验性慢性胰腺炎动物模型,利用实时荧光定量PCR、ELISA、免疫组化和Western-blot等手段检测白介素-17A在雨蛙肽诱导的小鼠慢性胰腺炎模型中的表达变化及免疫活性。用重组白介素-17A作用于小鼠胰腺星状细胞,检测其对星状细胞活化的作用,并进一步探究其对促胰腺纤维化炎症因子白介素-6、白介素-1β、TGF-β在mRNA水平的表达变化。结果:慢性胰腺炎胰腺组织中白介素-17A受体IL-17RA及IL-17RC mRNA水平的表达较正常胰腺明显升高,慢性胰腺炎小鼠胰腺组织中IL-17A蛋白水平较正常小鼠明显升高,CP小鼠血清中IL-17A蛋白水平(56.40±10.50 pg/L)较NC组(27.88±5.74pg/L)亦明显升高,IL-17A在正常胰腺组织中鲜有表达(8.9±2.72%),而在CP组织中呈强阳性表达(55.84±5.71%),其免疫活性主要定位于间质炎性细胞及导管样复合体中;重组白介素-17A可促进小鼠星状细胞活化,并直接诱导星状细胞表达白介素-6、白介素-1β以及TGF-β等促纤维化细胞因子。结论:白介素-17A在雨蛙肽诱导的小鼠慢性胰腺炎模型中表达上调,并可能通过诱导小鼠星状细胞表达促炎细胞因子白介素-6、白介素-1β和TGF-β,促进胰腺星状细胞活化以及胰腺纤维化。     

慢性胰腺炎胰腺纤维化发病机制研究新进展

慢性胰腺炎(chronic pancreatitis, CP)是由多种因素引起的胰腺内外分泌功能紊乱,可导致胰腺结构和功能发生不可逆性损伤,是临床常见的消化系统疾病。CP的病理特点是腺泡细胞损伤导致巨噬细胞等多种炎症细胞浸润,从而分泌大量促炎细胞因子,在胰腺组织微环境中引起胰腺星状细胞活化,进而产生大量的细胞外基质,表现为胰腺纤维化。而新近的研究提示:胰腺纤维化是一种动态病理现象,需要由多种自分泌和旁分泌的细胞因子组成复杂的网络,作用于相应的信号通路,最终导致纤维化形成。现以CP胰腺组织微环境中出现的主要细胞,如胰腺星状细胞、巨噬细胞、腺泡细胞及其在CP胰腺纤维化进展中的变化和作用为切入点,对CP胰腺纤维化的发病机制研究进展做一综述。     

胰腺星状细胞的调控及转归

活化的胰腺星状细胞(pancreatic stellate cells,PSCs)是胰腺炎致胰腺纤维化的主要效应细胞。近年来,学者普遍认为,胰腺纤维化早期阶段是动态可逆的,因此,若在胰腺损伤的早期阶段,抑制PSCs的增殖、迁移,减少损伤部位PSCs的数目,降低细胞外基质(extracellular matrix,ECM)的生成,将可能逆转胰腺纤维化。该文以PSCs为靶点阐述了抗胰腺纤维化的新策略。     

胰腺应激蛋白PSP/reg抑制胰腺星状细胞TIMPs:MMPs及RECK表达

目的 观察胰腺应激蛋白PSP/reg对胰腺星状细胞(PSC)合成和分泌基质金属蛋白酶(MMPs)及其组织抑制剂(TIMPs)以及RECK表达的影响.方法 分离纯化慢性胰腺炎患者纤维化区的PSC,基因重组胰腺应激蛋白PSP/reg,以终浓度为10和100 ng/mL对PSC进行干预,实时荧光定量PCR检测MMP1/2、TIMP1/2及RECK基因表达,Western blot测定MMP1/2、TIMP1/2及RECK蛋白,细胞免疫荧光观察细胞膜表面RECK分布.结果 PSP/reg对MMP1/2、TIMP1/2及RECK表达无明显影响;PSP/reg轻度抑制PSC培养上清中MMP2水平(P＜0.05),而显著抑制TIMP1/2水平(P ＜0.01);PSC细胞膜表面发现有RECK蛋白,PSP/reg减少PSC的RECK含量(P＜0.01).结论 胰腺应激蛋白PSP/reg能够降低TIMPs:MMPs比率、减少RECK蛋白水平表达,从而解除对MMPs的部分抑制,使MMPs活性相对增高,有利于纤维化的分解消散,促进胰腺损伤后的再生修复.     

胰腺星状细胞活化相关的信号转导通路

胰腺纤维化是慢性胰腺炎（chronic pancreatitis,CP）和胰腺癌主要的病理学特征,活化的胰腺星状细胞（pancreatic stellate cells,PSCs）是公认的致胰腺纤维化的主要效应细胞。PSCs的活化涉及到几个重要的信号转导通路：有丝分裂原活化蛋白激酶（mitogen-activated protein kinases,MAPK）、磷酯酰肌醇3激酶（phosphatidylinositol 3-kinase,PI3K）=、Smad信号转导蛋白、过氧化物酶体增生物激活受体-γ（PPAR-γ）、Rho-ROCK等细胞内信号途径。探讨这些信号通路在胰腺纤维化中所起的作用对慢性胰腺炎、胰腺癌及糖尿病的治疗有重要意义。现就与PSCs激活有关的信号通路的研究结合最新进展作一综述。     

人肝星状细胞激活和抑制及其相关分子机制的研究进展

肝纤维化是肝脏对一系列慢性刺激的损伤修复反应,以细胞外基质的过度沉积为主要特征。许多研究证明人肝星状细胞(hepatic stellate cells,HSCs)的活化与增殖是肝纤维化形成的中心环节。因此,肝星状细胞激活机制及抑制活化途径的研究和发现成为防治肝纤维化的关键。目前,国际上肝纤维化药物研发的思路之一是从肝纤维化发生的机制,即肝星状细胞激活机制中寻找分子靶点。近年来,对各种使肝星状细胞活化的信号通路及相关抑制机制的研究取得了一些进展,但由于肝星状细胞活化是多条信号通路相互协调的结果,其复杂性、未知性造成了阻断方式的特异性、多样性,使该研究还仅限于实验室阶段,要想应用于临床还需要大量实验证明。该文就最新发现的肝星状细胞激活和抑制及相关分子机制作一综述。     

胰腺微环境外泌体miRNA参与胰腺炎症和纤维化的发病机制研究进展

慢性胰腺炎(chronic pancreatitis, CP)发病率逐年上升，目前尚无明确根治性治疗方法且后期有进展为胰腺癌的风险。CP的典型病理学特征是胰腺慢性炎症和纤维化，CP进展与胰腺微环境中三种主要细胞(腺泡细胞、巨噬细胞以及胰腺星状细胞)间的相互作用密切相关，然而它们具体是如何进行细胞间联系的目前尚不清楚。新近研究表明外泌体作为细胞间重要的通讯介质，其携带的miRNA可通过调控主要细胞内基因表达和信号通路等影响CP的发生发展。本文围绕胰腺微环境中外泌体来源miRNA与三种主要细胞相互作用的机制，对其最新研究进展进行归纳和总结分析，以期为CP发病机制的深入认识提供参考。     

细胞珠蛋白对肝星状细胞氧化损伤的保护作用

为揭示细胞珠蛋白对肝星状细胞氧化损伤的保护作用及相关机制,通过siRNA干扰内源性细胞珠蛋白基因,利用重组细胞珠蛋白作用于完全活化的人肝星状细胞系LX-2及大鼠原代肝星状细胞,并在LX-2细胞内过表达细胞珠蛋白,考察在过氧化氢及铁过载两种不同作用机制的氧化反应模型中细胞的增殖性及细胞内超氧化物水平。结果表明内源性细胞珠蛋白对于两种氧化反应导致的肝星状细胞损伤都具有显著性的保护作用,证明其在活化肝星状细胞内的表达上调是其应对氧化应激的保护性措施;重组细胞珠蛋白不仅能保护完全活化的LX-2细胞免受氧化应激损伤,并且能抑制未完全活化的原代肝星状细胞过度增殖以及保护其被过度损伤;重组细胞珠蛋白对细胞内的活性氧清除效果不理想,可能与其进出细胞缺乏相应的主动运输机制有关。进一步在LX-2细胞内过表达细胞珠蛋白对无论是铁过载或是过氧化氢引起的氧化反应均能发挥较好的保护性作用。为加速肝纤维化药物新靶点开发提供了理论依据。     

The inhibitory effects of Nardostachys jatamansi on alcoholic chronic pancreatitis

Nardostachys jatamansi (NJ) belonging to the Valerianaceae family has been used as a remedy for gastrointestinal inflammatory diseases for decades. However, the potential for NJ to ameliorate alcoholic chronic pancreatitis (ACP) is unknown. The aim of this study was to examine the inhibitory effects of NJ on ACP. C57black/6 mice received ethanol injections intraperitoneally for 3 weeks against a background of cerulein-induced acute pancreatitis. During ACP, NJ was ad libitum administrated orally with water. After 3 weeks of treatment, the pancreas was harvested for histological examination. NJ treatment increased the pancreatic acinar cell survival (confirmed by amylase level testing) and reduced collagen deposition and pancreatic stellate cell (PSC) activation. In addition, NJ treatment reduced the activation but not death of PSC. In conclusion, our results suggest that NJ attenuated ACP through the inhibition of PSC activation.     

Cannabinoids reduce markers of inflammation and fibrosis in pancreatic stellate cells

Background

While cannabinoids have been shown to ameliorate liver fibrosis, their effects in chronic pancreatitis and on pancreatic stellate cells (PSC) are unknown.

Methodology/Principal Findings

The activity of the endocannabinoid system was evaluated in human chronic pancreatitis (CP) tissues. In vitro, effects of blockade and activation of cannabinoid receptors on pancreatic stellate cells were characterized. In CP, cannabinoid receptors were detected predominantly in areas with inflammatory changes, stellate cells and nerves. Levels of endocannabinoids were decreased compared with normal pancreas. Cannabinoid-receptor-1 antagonism effectuated a small PSC phenotype and a trend toward increased invasiveness. Activation of cannabinoid receptors, however, induced de-activation of PSC and dose-dependently inhibited growth and decreased IL-6 and MCP-1 secretion as well as fibronectin, collagen1 and alphaSMA levels. De-activation of PSC was partially reversible using a combination of cannabinoid-receptor-1 and -2 antagonists. Concomitantly, cannabinoid receptor activation specifically decreased invasiveness of PSC, MMP-2 secretion and led to changes in PSC phenotype accompanied by a reduction of intracellular stress fibres.

Conclusions/Significance

Augmentation of the endocannabinoid system via exogenously administered cannabinoid receptor agonists specifically induces a functionally and metabolically quiescent pancreatic stellate cell phenotype and may thus constitute an option to treat inflammation and fibrosis in chronic pancreatitis.     

Phenotypic changes in mouse pancreatic stellate cell Ca2+ signaling events following activation in culture and in a disease model of pancreatitis

The specific characteristics of intracellular Ca 2+ signaling and the downstream consequences of these events were investigated in mouse pancreatic stellate cells (PSC) in culture and in situ using multiphoton microscopy in pancreatic lobules. PSC undergo a phenotypic transformation from a quiescent state to a myofibroblast-like phenotype in culture. This is believed to parallel the induction of an activated state observed in pancreatic disease such as chronic pancreatitis and pancreatic cancer. By day 7 in culture, the complement of cell surface receptors coupled to intracellular Ca 2+ signaling was shown to be markedly altered. Specifically, protease-activated receptors (PAR) 1 and 2, responsive to thrombin and trypsin, respectively, and platelet-derived growth factor (PDGF) receptors were expressed only in activated PSC (aPSC). PAR-1, ATP, and PDGF receptor activation resulted in prominent nuclear Ca 2+ signals. Nuclear Ca 2+ signals and aPSC proliferation were abolished by expression of parvalbumin targeted to the nucleus. In pancreatic lobules, PSC responded to agonists consistent with the presence of only quiescent PSC. aPSC were observed following induction of experimental pancreatitis. In contrast, in a mouse model of pancreatic disease harboring elevated K-Ras activity in acinar cells, aPSC were present under control conditions and their number greatly increased following induction of pancreatitis. These data are consistent with nuclear Ca 2+ signaling generated by agents such as trypsin and thrombin, likely present in the pancreas in disease states, resulting in proliferation of "primed" aPSC to contribute to the severity of pancreatic disease.     

CCK1 and CCK2 Receptors Are Expressed on Pancreatic Stellate Cells and Induce Collagen Production

The gastrointestinal hormone cholecystokinin (CCK) can induce acute pancreatitis in rodents through its action on acinar cells. Treatment with CCK, in combination with other agents, represents the most commonly used model to induce experimental chronic pancreatitis. Pancreatic stellate cells (PSC) are responsible for pancreatic fibrosis and therefore play a predominant role in the genesis of chronic pancreatitis. However, it is not known whether PSC express CCK receptors. Using real time PCR techniques, we demonstrate that CCK1 and CCK2 receptors are expressed on rat PSC. Interestingly both CCK and gastrin significantly induced type I collagen synthesis. Moreover, both inhibit proliferation. These effects are comparable with TGF-β-stimulated PSC. Furthermore, the natural agonists CCK and gastrin induce activation of pro-fibrogenic pathways Akt, ERK, and Src. Using specific CCK1 and CCK2 receptor (CCK2R) inhibitors, we found that Akt activation is mainly mediated by CCK2R. Akt activation by CCK and gastrin could be inhibited by the PI3K inhibitor wortmannin. Activation of ERK and the downstream target Elk-1 could be inhibited by the MEK inhibitor U0126. These data suggest that CCK and gastrin have direct activating effects on PSC, are able to induce collagen synthesis in these cells, and therefore appear to be important regulators of pancreatic fibrogenesis. Furthermore, similar to TGF-β, both CCK and gastrin inhibit proliferation in PSC.     

Connective tissue growth factor (CCN2) and microRNA-21 are components of a positive feedback loop in pancreatic stellate cells (PSC) during chronic pancreatitis and are exported in PSC-derived exosomes

Pancreatitis is an inflammatory condition of the pancreas which, in its chronic form, involves tissue destruction, exocrine and endocrine insufficiency, increased risk of pancreatic cancer, and an extensive fibrotic pathology which is due to unrelenting collagen deposition by pancreatic stellate cells (PSC). In response to noxious agents such as alcohol—excessive consumption of which is a major cause of pancreatitis in the West—normally quiescent PSC undergo a phenotypic and functional transition to activated myofibroblasts which produce and deposit collagen at high levels. This process is regulated by connective tissue growth factor (CCN2), expression of which is highly up-regulated in activated PSC. We show that CCN2 production by activated PSC is associated with enhanced expression of microRNA-21 (miR-21) which was detected at high levels in activated PSC in a murine model of alcoholic chronic pancreatitis. A positive feedback loop between CCN2 and miR-21 was identified that resulted in enhancement of their respective expression as well as that of collagen α1(I). Both miR-21 and CCN2 mRNA were present in PSC-derived exosomes, which were characterized as 50–150 nm CD9-positive nano-vesicles. Exosomes from CCN2-GFP- or miR-21-GFP-transfected PSC were taken up by other PSC cultures, as shown by direct fluorescence or qRT-PCR for GFP. Collectively these studies establish miR-21 and CCN2 as participants in a positive feedback loop during PSC activation and as components of the molecular payload in PSC-derived exosomes that can be delivered to other PSC. Thus interactions between cellular or exosomal miR-21 and CCN2 represent novel aspects of fibrogenic regulation in PSC. Summary Chronic injury in the pancreas is associated with fibrotic pathology which is driven in large part by CCN2-dependent collagen production in pancreatic stellate cells. This study shows that CCN2 up-regulation in PSC is associated with increased expression of miR-21 which, in turn, is able to stimulate CCN2 expression further via a positive feedback loop. Additionally miR-21 and CCN2 were identified in PSC-derived exosomes which effected their delivery to other PSC. The cellular and exosomal miR-21-CCN2 axis is a novel component in PSC fibrogenic signaling.     

Effects of fibrogenic mediators on the development of pancreatic fibrosis in a TGF-beta1 transgenic mouse model

The pancreas morphology of transgenic mice that overexpress transforming growth factor-beta1 (TGF-beta1) in the pancreas resembles partially morphological features of chronic pancreatitis, such as progressive accumulation of extracellular matrix (ECM). Using this transgenic mouse model, we characterized the composition of pancreatic fibrosis and involved fibrogenic mediators. On day 14 after birth, fibrotic tissue was mainly composed of collagen type I and III. At this time, mRNA levels of TGF-beta1 were increased. On day 70, the ECM composition was expanded by increased deposition of fibronectin, whereas connective tissue growth factor, fibroblast growth factor (FGF)-1, and FGF-2 mRNA expression levels were elevated in addition to TGF-beta1. In parallel, the number of pancreatic stellate cells (PSC) increased over time. In vitro, TGF-beta1 stimulated collagen type I expression but not fibronectin expression in PSC, in contrast to FGF-2, which stimulated both. This confirms that TGF-beta1 mediates pancreatic fibrosis through activation of PSC and deposition of collagen type I and III at early time points. Furthermore, this points to an indirect mechanism in which TGF-beta regulates pancreatic ECM assembly by induction of additional growth factors.