MTHFR C677T polymorphism in chronic pancreatitis and pancreatic adenocarcinoma

Chronic pancreatitis and pancreatic adenocarcinoma are extensively studied as common and potentially lethal disorders. However, their causes and genetic background in most cases remain unclear. The C677T polymorphism in 5',10'-methylenetetrahydrofolate reductase (MTHFR) gene may modulate the risk of pancreatic disorders. In this study, we tested whether MTHFR C677T polymorphism is associated with chronic pancreatitis and pancreatic adenocarcinoma in the Serbian population. DNA was extracted from blood samples of 51 chronic pancreatitis patients, 21 pancreatic adenocarcinoma patients, and a control group consisting of 50 healthy smokers. The MTHFR C677T polymorphism was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Although, no statistically significant differences were observed in the distribution of MTHFR genotype or allele frequencies between patients and control groups, the results showed an increased frequency of homozygotes for MTHFR C677T polymorphism in chronic pancreatitis patients (14%) and a decreased frequency in pancreatic adenocarcinoma patients (5%) in comparison to the control group (8%). We speculate that the MTHFR C677T polymorphism could act as a possible risk factor for chronic pancreatitis and a possible protective factor in pancreatic adenocarcinoma. This observation needs further investigation in prospective studies on a larger number of patients, in which the effect of other genetic and environmental factors should also be taken into consideration.     

Proteomic profiling in an animal model of acute pancreatitis

Acute pancreatitis (AP) is an inflammatory disease of the pancreas, which evolves in approximately 20% of the patients to a severe illness associated with a high mortality rate. In this study, we performed a comparative proteomic analysis of pancreatic tissue extracts from rats with AP and healthy rodent controls in order to identify changes in protein expression related to the pathobiological processes of this disease. Pancreatic extracts from diseased and controls rats were analyzed by 2-DE and MS/MS. A total of 125 proteins were identified from both samples. Comparative analysis allowed the detection of 42 proteins or protein fragments differentially expressed between diseased and control pancreas, some of them being newly described in AP. Interestingly, these changes were representative of the main pathobiological pathways involved in this disease. We observed activation of digestive proteases and increased expression of various inflammatory markers, including several members of the alpha-macroglobulin family. We also detected changes related to oxidative and cell stress responses. Finally, we highlighted modifications of 14-3-3 proteins that could be related to apoptosis regulation. These results showed the interest of proteomic analysis to identify changes characterizing pancreatic tissue damage and, therefore, to highlight new potential biomarkers of AP.     

急性胰腺炎大鼠腺泡细胞凋亡及X连锁凋亡抑制蛋白XIP的表达

目的:研究急性胰腺炎(AP)大鼠腺泡细胞凋亡,X连锁凋亡抑制蛋白(XIAP)的表达及其与疾病严重程度的关系。方法:通过胰胆管逆行注射不同浓度的牛黄胆酸钠,制备急性水肿型胰腺炎(AEP)和急性坏死性胰腺炎(ANP)大鼠模型,同时设假手术(SO)组为对照。收集各模型组3,6和12h标本,对胰腺组织进行病理学评分,并测定血清淀粉酶和腹水量;用TUNEL染色检测胰腺腺泡细胞的凋亡,分别RT-PCR和Western Blotting法测定大鼠胰腺组织XIAP mRNA及蛋白的表达。结果:成功建立了大鼠AP模型。同SO组相比,ANP和AEP组胰腺组织在各时间点均有不同程度的病理损害,血清淀粉酶也显著增高(P均<0.01)。且ANP组显著高于AEP组(P均<0.01)。造模成功3h后,各组大鼠胰腺腺泡细胞均出现少量凋亡,但ANP和AEP组凋亡显著多于SO组(P<0.05),ANP和AEP组间没有差别(P>0.05)。同SO组相比,ANP和AEP组在6h和12h时凋亡均增多(P<0.01),且AEP组显著高于ANP组(P<0.01)。造模成功3h后,各模型组XIAP mRNA表达没有差异(P>0.05);6h和12h时AEP组XIAP mRNA表达明显下降,而ANP组明显升高,两组间差异有显著性(P<0.01)。XIAP蛋白表达水平与mRNA表达水平相一致。结论:急性胰腺炎大鼠胰腺组织XIAP表达与腺泡细胞凋亡情况相反,且与疾病严重程度平行。XIAP可能负性调控AP大鼠胰腺腺泡细胞的凋亡。     

Attenuation of Zn-Induced Acute Pancreatitis in Wistar Rat Fed on Cu- and Mg- Enriched Modified Poultry Egg^{\Psi }

Zinc (Zn) consumption has increased in many populations either due to the increased intake of Zn-fortified foods as in the USA or in agricultural food stuffs as in some Indian states during the last decade. Its excessive intake has been reported to induce acute pancreatitis (AP) in many studies due to increase in oxidative stress that was further reported to cause Cu and Mg deficiencies. This led us to design a modified poultry egg (ME^Ψ) enriched with Cu and Mg along with other antioxidants, and its efficacy on Zn-induced AP was studied in male Wistar rats. In one set, the rats were fed on equacaloric semi-synthetic basal diet containing 20 mg Zn/kg diet (control, group I), and Zn-induced AP-I diet and AP-II diet containing 40 and 80 mg Zn/kg diet (groups II and III) for 180 days, respectively. In another set, the rats were initially fed on Zn-induced AP-I and AP-II diets for 90 days and then shifted to -mixed Zn-induced AP-I and AP-II diets in groups IIME and IIIME for another 90 days. At the end of the experiment, data displayed increased serum and urinary Zn, Cu, and Mg levels in groups II and III rats, which were reduced and approached closer to control group I after feeding in groups IIME and IIIME rats. Transmission electron microscopic studies of acinar cells revealed progressive dilation, vesicularization, and degeneration of endoplasmic reticulum (ER), and decrease in zymogen granules (ZG) in groups II and III rats in contrast to their curvilinear or concentric long parallel running cisternal profile of ER in control group I. The treatment of helped in the restoration of the ER profile and ZG number, approaching closer to the control group I. The degree of recovery was dependent upon the degree of toxicity caused by the amount of Zn given in the diet. The results of this study suggest that -mixed diet can protect the acinar cells from the deleterious effects of Zn by decreasing the oxidative stress. Indian patent application no. 2264/Del/2005.     

Synergistic inhibitory activity of α- and β-LFA-1 peptides on LFA-1/ICAM-1 interaction

Interactions of cell-adhesion molecule LFA-1 and its ligand ICAM-1 play important roles during immune and inflammatory responses. Critical residues of LFA-1 for ICAM-1 binding are known to be in the I-domain of the α-subunit and the I-like domain of the β-subunit. On the basis of our previous work demonstrating the inhibitory activity of I-domain cyclic peptide cLAB.L on LFA-1/ICAM-1 interaction, here we have explored the activity of I-like-domain peptide LBE on the binding mechanism of cLAB.L. LBE enhances cLAB.L binding to T-cells and epithelial cells. The adherence of T-cells to epithelial monolayers was suppressed by the two peptides. The addition of LBE to the monolayers prior to the addition cLAB.L produced a better inhibitory effect than the reverse procedure. LBE, but not cLAB.L, changes the ICAM-1 conformation, suggesting that LBE binds to ICAM-1 at sites that are distinct from these of cLAB.L and induces improved conformation in ICAM-1 for binding to cLAB.L.     

The role of interleukin-18 in pancreatitis and pancreatic cancer

Originally described as an interferon (IFN)-γ-inducing factor, interleukin (IL)-18 has been reported to be involved in Th1 and Th2 immune responses, as well as in activation of NK cells and macrophages. There is convincing evidence that IL-18 plays an important role in various pathologies (i.e. inflammatory diseases, cancer, chronic obstructive pulmonary disease, Crohn's disease and others). Recently, IL-18 has also been shown to execute specific effects in pancreatic diseases, including acute and chronic pancreatitis, as well as pancreatic cancer. The aim of this study was to give a profound review of recent data on the role of IL-18 and its potential as a therapeutic target in pancreatic diseases. The existing data on this topic are in part controversial and will be discussed in detail. Future studies should aim to confirm and clarify the role of IL-18 in pancreatic diseases and unravel their molecular mechanisms.     

Pancreatitis severity in mice with impaired CFTR function but pancreatic sufficiency is mediated via ductal and inflammatory cells-Not acinar cells

Mutations in the cystic fibrosis transmembrane conductance regulator gene (CFTR) are an established risk factor for cystic fibrosis (CF) and chronic pancreatitis. Whereas patients with CF usually develop complete exocrine pancreatic insufficiency, pancreatitis patients with CFTR mutations have mostly preserved exocrine pancreatic function. We therefore used a strain of transgenic mice with significant residual CFTR function (CFTR^tm1HGU) to induce pancreatitis experimentally by serial caerulein injections. Protease activation and necrosis were investigated in isolated acini, disease severity over 24h, pancreatic function by MRI, isolated duct stimulation and faecal chymotrypsin, and leucocyte function by ex vivo lipopolysaccharide (LPS) stimulation. Pancreatic and lung injury were more severe in CFTR^tm1HGU but intrapancreatic trypsin and serum enzyme activities higher than in wild-type controls only at 8h, a time interval previously attributed to leucocyte infiltration. CCK-induced trypsin activation and necrosis in acini from CFTR^tm1HGU did not differ from controls. Fluid and bicarbonate secretion were greatly impaired, whereas faecal chymotrypsin remained unchanged. LPS stimulation of splenocytes from CFTR^tm1HGU resulted in increased INF-γ and IL-6, but decreased IL-10 secretion. CFTR mutations that preserve residual pancreatic function significantly increase the severity of experimental pancreatitis—mostly via impairing duct cell function and a shift towards a pro-inflammatory phenotype, not by rendering acinar cells more susceptible to pathological stimuli.     

肠内营养支持联合益生菌促进重症急性胰腺炎患者恢复的临床机制研究

目的阐述益生菌联合肠内营养支持对改善重症急性胰腺炎患者肠道微生态以及粘膜屏障功能的临床应用价值。方法选取我院收治的100例重症急性胰腺炎患者作为研究对象,随机分为观察组和对照组,各50例。观察组患者接受益生菌制剂联合肠内营养,对照组患者仅接受肠内营养,持续2周。比较两组患者的血浆生化指标、胃肠道功能、肠粘膜屏障功能、并发症发生率、病死率及住院时间。收集两组患者的粪便,检测菌群变化。结果在治疗第7 d,观察组患者的白细胞数和血浆生化指标明显低于对照组。治疗第14 d,观察组生化检测指标均明显低于对照组。胃肠道功能评分方面,治疗第7、14 d,观察组评分均较对照组明显降低；治疗第7 d、14 d,两组患者血浆MDA、ET、CRP水平和尿L/M均出现明显下降,观察组较对照组下降更明显；观察组的总体并发症发生率及住院时间与对照组比较,具有统计学差异。实时荧光定量PCR结果显示,经过14 d治疗后观察组患者大肠埃希菌、肺炎克雷伯菌的数量明显低于对照组。对照组病人双歧杆菌和乳酸菌数量明显高于对照组。结论肠内营养治疗联合益生菌有利于促进重症急性胰腺炎肠道功能的恢复,值得在临床上应用推广。     

Discovery of orally efficacious RORγt inverse agonists. Part 2: Design,synthesis, and biological evaluation of novel tetrahydroisoquinoline derivatives

A series of tetrahydroisoquinoline derivatives were designed, synthesized, and evaluated for their potential as novel orally efficacious retinoic acid receptor-related orphan receptor-gamma t (RORγt) inverse agonists for the treatment of Th17-driven autoimmune diseases. We carried out cyclization of the phenylglycinamide core by structure-based drug design and successfully identified a tetrahydroisoquinoline carboxylic acid derivative 14 with good biochemical binding and cellular reporter activity. Interestingly, the combination of a carboxylic acid tether and a central fused bicyclic ring was crucial for optimizing PK properties, and the compound 14 showed significantly improved PK profile. Successive optimization of the carboxylate tether led to the discovery of compound 15 with increased inverse agonistic activity and an excellent PK profile. Oral treatment of mice with compound 15 robustly and dose-dependently inhibited IL-17A production in an IL23-induced gene expression assay.