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.     

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.     

A single-nucleotide polymorphism in tumor necrosis factor-α (− 308 G/A) as a biomarker in chronic pancreatitis

Objective

Chronic pancreatitis is a gradual, long-term inflammation of the pancreas that results in alteration of its normal structure and function. The study aims to investigate the role of − 308 (G/A) polymorphism of TNF-α gene in chronic pancreatitis.

Material and methods

A total of 200 subjects were included in this case–control study. A total of 100 in patients admitted in the Gastroenterology Unit of Gandhi Hospital and Osmania General Hospital, Hyderabad were included in the present study. An equal number of healthy control subjects were randomly selected for the study. The genotyping of TNF-α gene was carried out by tetra-primer ARMS PCR followed by gel electrophoresis. The TNF-α levels were assayed by enzyme-linked immunosorbent assay.

Results

A significant variation with respect to the genotypic and allelic distribution in the disease group when compared to control subjects [OR = 2.001 (1.33–3.005), p < 0.0001**] was observed. Subjects homozygous for the A allele had higher TNF-α levels compared to G allele.

Conclusion

The present study revealed a significant association of the TNF-α gene promoter polymorphism with chronic pancreatitis. Thus, TNF-α genotype can be considered as one of the biological markers in the etiology of chronic pancreatitis.     

Isoliquiritigenin ameliorates caerulein‐induced chronic pancreatitis by inhibiting the activation of PSCs and pancreatic infiltration of macrophages

Chronic pancreatitis (CP) is characterized by persistent inflammation of the pancreas that results in progressive loss of the endocrine and exocrine compartment owing to atrophy and/or replacement with fibrotic tissue. Currently, the clinical therapeutic scheme of CP is mainly symptomatic treatment including pancreatic enzyme replacement, glycaemic control and nutritional support therapy, lacking of specific therapeutic drugs for prevention and suppression of inflammation and fibrosis aggravating in CP. Here, we investigated the effect of isoliquiritigenin (ILG), a chalcone‐type dietary compound derived from licorice, on pancreatic fibrosis and inflammation in a model of caerulein‐induced murine CP, and the results indicated that ILG notably alleviated pancreatic fibrosis and infiltration of macrophages. Further in vitro studies in human pancreatic stellate cells (hPSCs) showed that ILG exerted significant inhibition on the proliferation and activation of hPSCs, which may be due to negative regulation of the ERK1/2 and JNK1/2 activities. Moreover, ILG significantly restrained the M1 polarization of macrophages (RAW 264.7) via attenuation of the NF‐κB signalling pathway, whereas the M2 polarization was hardly affected. These findings indicated that ILG might be a potential anti‐inflammatory and anti‐fibrotic therapeutic agent for CP.     

Abdominal paracentesis drainage attenuates intestinal mucosal barrier damage through macrophage polarization in severe acute pancreatitis

Abdominal paracentesis drainage (APD), as an effective treatment of severe acute pancreatitis (SAP) in clinical settings, can ameliorate intestinal barrier damage and the overall severity of SAP. However, the mechanism underlying therapeutic effects of APD on damaged intestinal mucosal barrier during SAP is still unclear. Here, SAP was induced by injecting 5% Na-taurocholate retrograde into the biliopancreatic duct of rats to confirm the benefits of APD on enteral injury of SAP and further explore the possible mechanism. Abdominal catheter was placed after SAP was induced in APD group. As control group, the sham group received no operation except abdominal opening and closure. By comparing changes among control group, sham group, and APD group, APD treatment obviously lowered the intestinal damage and reduced the permeation of intestinal mucosal barrier, which was evidenced by intestinal H&E staining, enteral expression of tight junction proteins, intestinal apoptosis measurement and detection of serum diamine oxidase, intestinal fatty acid binding protein and D-lactic acid. Furthermore, we found that APD polarized intestinal macrophages toward M2 phenotype by the determination of immunofluorescence and western blotting, and this accounts for the benefits of APD for intestinal injury in SAP. Importantly, the protective effect against intestinal injury by APD treatment was mediated through the inhibited ASK1/JNK pathway. In summary, APD improved the intestinal mucosal barrier damage in rats with SAP through an increasing portion of M2 phenotype macrophages in intestine via inhibiting ASK1/JNK pathway.     

Effect of microRNA-27a-5p on apoptosis and inflammatory response of pancreatic acinar cells in acute pancreatitis by targeting PTEN

To investigate the apoptosis and inflammatory response of microRNA-27a-5p (miR-27a-5p) in pancreatic acinar cells of acute pancreatitis (AP) and its related mechanisms. Rat pancreatic acinar cell line AR42J was treated with caerulein (10nmol/L) to construct an acute pancreatitis cell model. Quantitative real-time polymerase chain reaction was performed to measure the expression of miR-27a-5p; The miR-27a-5p mimic was transfected into cell, and the apoptosis rate of the cells was detected by flow cytometry; The levels of TNF-α, IL-1, and IL-6 in the culture supernatant were determined by enzyme-linked immunosorbent assay; TargetScans database predicted and dual luciferase reporter gene assay verified the relationship between miR-27a-5p and the phosphatase and tensin homolog deleted on chromosome 10 (PTEN); The recovery experiment explored the apoptosis and the effects of inflammatory responses. The expression of miR-27a-5p decreased gradually (P < 0.05) and the expression of PTEN increased gradually (P < 0.05) with the prolongation of acting time. Upregulation of miR-27a-5p significantly promoted cell apoptosis (P < 0.05) and inhibited inflammatory response (P < 0.05); The TargetScans database predicted that the 3'UTR of PTEN contains a base complementary to the miR-27a-5p seed region. Cotransfection of wild-type vector (PTEN-WT) with miR-27a-5p mimic or miR-27a-5p inhibitor significantly affected the relative activity of luciferase (P < 0.05), and no significant impact was observed in mutant PTEN-MUT. Compared with miR-27a-5p + pcDNA group, transfection of miR-27a-5p mimic and pcDNA-PTEN significantly increased the expression of PTEN (P < 0.05), decreased the apoptotic rate (P < 0.05), and increased the inflammatory response (P < 0.05). miR-27a-5p induced apoptosis and inhibited the inflammatory response of pancreatic acinar cells in AP by targeting PTEN.     

Expression of mutated cationic trypsinogen reduces cellular viability in AR4-2J cells

Mutations in the human cationic trypsinogen are associated with hereditary pancreatitis. The cDNA coding for human cationic trypsinogen was subcloned into the expression vector pcDNA3. The mutations R122H, N29I, A16V, D22G, and K23R were introduced by site directed mutagenesis. We constructed an expression vector coding for active trypsin by subcloning the cDNA of trypsin lacking the coding region for the trypsin activating peptide behind an appropriate signal peptide. Expression of protein was verified by Western blot and measurement of enzymatic activity. AR4-2J cells were transiently transfected with the different expression vectors and cell viability and intracellular caspase-3 activity were quantified. In contrast to wild-type trypsinogen, expression of active trypsin and mutated trypsinogens reduced cell viability of AR4-2J cells. Expression of trypsin and R122H trypsinogen induced caspase-3 activity. Acinar cells might react to intracellular trypsin activity by triggering apoptosis.     

饥饿及雨蛙素诱导的AR42J 细胞中自噬基因LC3及beclin-1 表达的变化

目的:观察饥饿及雨蛙素诱导的大鼠胰腺腺泡细胞AR42J中自噬基因LC3及beclin-1表达的变化,初步探讨吞噬(autophagy)在急性胰腺炎中的作用。方法:选择体外培养的生长状态良好的大鼠胰腺腺泡AR42J细胞,随机分为3组,饥饿组(N=10),雨蛙素处理组(N=10),空白对照组(N=10)。饥饿组加入充足的平衡盐溶液,雨蛙素处理组加入含10-7mol/L雨蛙素的全营养培养液,空白对照组加入含20%灭活胎牛血清的F12-K培养液(p H7.2-7.4),各组分别于处理后2、4、6 h收集细胞并提取蛋白质。采用免疫印迹法检测三组不同时点胰腺腺泡细胞AR42J中自噬基因Beclin-1和LC3的蛋白表达。结果:空白对照组不同时点beclin-1和LC3-II均呈低表达,且各时点比较差异无统计学意义(P<0.05)。饥饿组和雨蛙素处理组beclin-1和LC3-II的表达随处理时间的延长逐渐增加,且不同时点beclin-1和LC3-II的表达均较空白对照组显著增高,差异均具统计学意义(P<0.05)。结论:雨蛙素和饥饿刺激可导致大鼠胰腺腺泡细胞AR42J中LC3-II及beclin-1蛋白表达随作用时间的延长而增加,自噬可能参与了胰腺炎的发生发展过程。     

生长抑素联合双歧杆菌四联活菌治疗急性胰腺炎的效果及对肠粘膜屏障功能的影响

目的:探究生长抑素联合双歧杆菌四联活菌治疗急性胰腺炎的效果及对肠粘膜屏障功能的影响。方法:选取2015年8月～2018年8月我院收治的急性胰腺炎患者98例,根据患者入院先后顺序分为两组。对照组患者给予生长抑素治疗,观察组在对照组的基础上联合双歧杆菌四联活菌片治疗。比较两组患者的临床治疗效果,临床症状和指标的恢复时间及胃肠动力的恢复情况,治疗前后D-乳酸、二胺氧化酶(DAO)和尿乳果糖和甘露醇的比值(L/M)水平的变化。结果:治疗后,观察组患者的总有效率显著高于对照组(P0.05),腹痛、腹胀、腹膜刺激征、血淀粉酶和尿淀粉酶恢复正常时间均显著短于对照组(P0.05)。治疗后,两组患者的血清D-乳酸、DAO和L/M水平均较治疗前显著下降,且观察组以上指标均显著低于对照组(P0.05)。此外,观察组患者的腹内压显著低于对照组,肠鸣音恢复时间显著短于对照组,胃肠减压引流量显著低于对照组(P0.05)。结论:与单用生长抑素相比,生长抑素联合双歧杆菌四联活菌可更迅速缓解急性胰腺炎患者的临床症状及指标,恢复胃肠动力,并显著改善患者的肠粘膜屏障功能,利于患者的康复。     

保留灌肠清胰汤联合ERCP治疗急性胆源性胰腺炎的疗效及机制探讨

目的:探讨保留灌肠清胰汤联合内镜逆行胰胆管造影术(endoscopic retrograde pancreatic cholangiography,ERCP)治疗急性胆源性胰腺炎的临床疗效及作用机制。方法:选择2015年1月～2017年12月我院收治的97例胆源性胰腺炎患者为研究对象,根据治疗方法不同,将其分为对照组(ERCP组,46例)及观察组(保留灌肠清胰汤联合ERCP组,53例)。观察和比较两组的中医临床疗效,治疗前后7天的肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、C反应蛋白(c-reactive protein,CRP)、白细胞介素-6(Interleukins-6,IL-6)、白细胞介素-8(Interleukin-8,IL-8)、白细胞介素-10(Interleukin-10,IL-10)水平及治疗前、治疗后12 h、24 h、3 d的血清淀粉酶水平的变化,腹痛缓解时间、平均住院时间、平均住院费用。结果:治疗后,观察组的痊愈、显效比例明显高于对照组(P0.05)。两组治疗后的血清TNF-α、CRP、IL-6、IL-8、IL-10水平均显著低于治疗前,且观察组的血清TNF-α、CRP、IL-6、IL-8水平均明显低于对照组(P均0.05);两组的平均住院费用对比差异无统计学意义(P0.05);观察组的腹痛缓解时间、平均住院时间明显低于对照组(P0.05)。与治疗前相比,两组治疗后12 h、24 h、3 d时的血清淀粉酶水平均显著降低,且观察组治疗后12 h、24 h时的血清淀粉酶水平均明显低于对照组(P均0.05)。结论:保留灌肠清胰汤联合ERCP治疗可显著提高急性胆源性胰腺炎的治疗痊愈率及有效率,其作用机制可能与降低患者血清TNF-α、CRP、IL-6、IL-8及淀粉酶水平有关。