Reg基因蛋白家族的研究进展

Reg基因蛋白（regenerating gene protein）属于钙依赖的植物血凝素超家族,其功能类似应激蛋白、抗凋亡因子或生长因子。Reg基因蛋白的促进胰岛β细胞分裂和诱导再生作用最早是在糖尿病研究中被发现。Reg基因蛋白在人体多种组织中均表达,与细胞增殖、炎症创伤、感染和神经系统发育关系密切。随着研究的深入,Reg基因蛋白在胰腺损伤修复、神经系统损伤、消化系统肿瘤、脓毒血症及其他疾病中的作用逐渐引起人们重视。     

清胰汤对大鼠急性坏死性胰腺炎IL-6,IL-10 及肠道通透性影响

目的:探讨清胰汤改善大鼠急性坏死性胰腺炎(acute necrotizing pancreatitis)ANP炎症反应及肠道通透性功能的治疗效果及机制。方法:将72只雄性SD大鼠随机分为3组,其中2组大鼠采用从胰腺被膜下多点缓慢均匀注入3.8%牛黄胆酸钠(0.5ml/100g)建立大鼠急性坏死性胰腺炎模型,再分为急性坏死性胰腺炎常规治疗组(A组)、清胰汤干预治疗组(B组),其他24只大鼠为假手术组(S组),每组再随机分为24h、48h、72h组。各组于12h后给于肠内营养,B组肠内营养后给于2次清胰汤2.5ml/100g,A组、S组给于同等剂量生理盐水。各组于建模后24h、48h、72h处死,腹腔动脉取血检测血清淀粉酶浓度、IL-6、IL-10、D-乳酸水平。结果:48h时点B组IL-10水平较A组高(P<0.05);72时点B组血清淀粉酶水平较A组低(P<0.01),IL-6水平较A组低(P<0.01),IL-10水平较A组高(P<0.01),D-乳酸水平较A组低(P<0.01)。结论:清胰汤可以上调IL-10改善大鼠急性胰腺炎炎症反应从而降低肠道通透性。     

Impact of diet and genes on murine autoimmune pancreatitis

The impact of environmental factors, such as diet, and the genetic basis of autoimmune pancreatitis (AIP) are largely unknown. Here, we used an experimental murine AIP model to identify the contribution of diet to AIP development, as well as to fine‐map AIP‐associated genes in outbred mice prone to develop the disease. For this purpose, we fed mice of an autoimmune‐prone intercross line (AIL) three different diets (control, calorie‐reduced and western diet) for 6 months, at which point the mice were genotyped and phenotyped for AIP. Overall, 269 out of 734 mice (36.6%) developed AIP with signs of parenchymal destruction, equally affecting mice of both sexes. AIP prevalence and severity were reduced by approximately 50% in mice held under caloric restriction compared to those fed control or western diet. We identified a quantitative trait locus (QTL) on chromosome 4 to be associated with AIP, which is located within a previously reported QTL. This association does not change when considering diet or sex as an additional variable for the mapping. Using whole‐genome sequences of the AIL founder strains, we resolved this QTL to a single candidate gene, namely Map3k7. Expression of Map3k7 was largely restricted to islet cells as well as lymphocytes found in the exocrine pancreas of mice with AIP. Our studies suggest a major impact of diet on AIP. Furthermore, we identify Map3k7 as a novel susceptibility gene for experimental AIP. Both findings warrant clinical translation.     

双歧杆菌乳杆菌三联活菌片联合血必净注射液对急性胰腺炎患者炎性介质、细胞免疫指标及肠黏膜屏障功能的影响

目的:探讨血必净注射液联合双歧杆菌乳杆菌三联活菌片治疗急性胰腺炎(SAP)患者的临床疗效。方法:选取2016年9月～2019年4月期间我院收治的SAP患者119例,根据随机数字表法将患者随机分为对照组(n=59)和研究组(n=60),对照组给予血必净注射液治疗,研究组在对照组的基础上联合双歧杆菌乳杆菌三联活菌片治疗,比较两组临床疗效,炎性介质、细胞免疫指标水平、肠黏膜屏障功能及不良反应发生情况。结果:研究组治疗7d后总有效率高于对照组(P0.05)。两组治疗期间未见药品不良反应发生。两组血清内毒素、二胺氧化酶(DAO)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)以及C反应蛋白(CRP)、CD8~+水平均降低,且研究组低于对照组(P0.05),CD4~+/CD8~+、CD4~+、NK细胞水平升高,且研究组高于对照组(P0.05)。结论:SAP患者在血必净的基础上联合双歧杆菌乳杆菌三联活菌片治疗,可提高机体细胞免疫功能,改善炎性因子水平和肠黏膜屏障功能,且用药安全性较好,临床应用价值较高。     

电针联合ICE抑制剂在急性胰腺炎的治疗中的作用及机制

观察和探讨电针联合白细胞介素(IL-1β)转化酶(ICE)抑制剂对炎症介质抑制和诱导急性胰腺炎腺泡细胞凋亡的作用。选取90只SD大鼠随机分为对照组、模型组和干预组,每组30只。各组造模后在第6小时、第12小时和第24小时各时间点分别检测10只大鼠。抑制剂组于造模前48 h采用电针并开始腹腔注射ICE抑制剂2.5 mg/100 mg体质量,间隔12 h注射1次。胰腺炎组仅在相同时间注射同等量的生理盐水。应用细胞凋亡原位标记(TUNEL)染色、ELISA方法等,检测血清中淀粉酶、肿瘤坏死因子-α(TNF-α)、IL-1β和胰腺细胞凋亡。HE染色见胰腺组织中典型的细胞核固缩及凋亡小体形成。干预组各个时间点病理学评分和血淀粉酶、TNF-α、IL-1β浓度均低于胰腺炎组,胰腺细胞凋亡指数高于胰腺炎组(p<0.05)。电针联合ICE抑制剂能减轻急性胰腺炎严重程度,其机制可能与其对炎症介质的抑制和诱导胰腺细胞的凋亡有关。     

Vasoactive intestinal peptide reduces oxidative stress in pancreatic acinar cells through the inhibition of NADPH oxidase

Vasoactive intestinal peptide (VIP) attenuates experimental acute pancreatitis (AP) by inhibition of cytokine production from inflammatory cells. It has been suggested that reactive oxygen species (ROS) as well as cytokines play pivotal roles in the early pathophysiology of AP. This study aimed to clarify the effect of VIP on the oxidative condition in pancreas, especially pancreatic acinar cells (acini). Hydrogen peroxide (H₂O₂)-induced intracellular ROS, assessed with CM-H₂DCFDA, increased time- and dose-dependently in acini isolated from rats. Cell viability due to ROS-induced cellular damage, evaluated by MTS assay, was decreased with ≥100 μmol/L H₂O₂. VIP significantly inhibited ROS production from acini and increased cell viability in a dose-dependent manner. Expression of antioxidants including catalase, glutathione reductase, superoxide dismutase (SOD) 1 and glutathione peroxidase was not altered by VIP except for SOD2. Furthermore, Nox1 and Nox2, major components of NADPH oxidase, were expressed in pancreatic acini, and significantly increased after H₂O₂ treatment. Also, NADPH oxidase activity was provoked by H₂O₂. VIP decreased NADPH oxidase activity, which was abolished by PKA inhibitor H89. These results suggested that VIP affected the mechanism of ROS production including NADPH oxidase through induction of a cAMP/PKA pathway. In conclusion, VIP reduces oxidative stress in acini through the inhibition of NADPH oxidase. These results combined with findings of our previous study suggest that VIP exerts its protective effect in pancreatic damage, not only through an inhibition of cytokine production, but also through a reduction of the injury caused by oxidative stress.     

骨髓间充质干细胞对重症急性胰腺炎胰腺组织修复的促进作用研究

目的观察骨髓间充质干细胞（BMSCs）抑制坏死性凋亡促进修复重症急性胰腺炎（SAP）的可能机理。 方法（1）分离、培养和鉴定大鼠BMSCs;（2）构建牛磺胆酸钠（NaT）诱导的SAP大鼠模型,并分成正常组（NC）、假手术组（Sham）、SAP模型组（SAP）、PBS治疗组（PBS）、BMSCs治疗组和Necrostain-1 （Nec-1）治疗组,并检测胰腺病理评分和血淀粉酶水平;（3）运用Western Blot和qRT-PCR方法检测各组受损胰腺组织内RIPK1、RIPK3、Caspase-8、MLKL蛋白及mRNA表达,各组均数间比较采用单因素方差分析,两两比较采用LSD-t检验。 结果BMSCs可以被诱导分化成骨、软骨、脂肪,并高表达CD44 （99.82﹪）、CD73 （99.87﹪）、CD90 （99.99﹪）、CD105 （99.78﹪）,低表达CD11b （0.65﹪）、CD19 （0.85﹪）、CD34 （0.70﹪）和CD45 （1.20﹪）。SAP组胰腺病理评分（12.90±1.79）及血淀粉酶水平（1052.41±183.12） mU/ ml均高于NC组[评分：0.40±0.52,淀粉酶水平：（236.62±33.21） mU/ ml]和Sham组[评分：0.50±0.53,淀粉酶水平：（242.31±27.94） mU/ ml]（F = 200.275,F = 143.245,P均< 0.001）,且SAP组受损胰腺组织内RIPK1、RIPK3、MLKL表达升高、Caspase-8表达降低（F = 179.905,P < 0.001）;BMSCs组和Nec-1治疗组胰腺病理评分及血淀粉酶水平均低于PBS治疗组[评分：7.20±1.23、7.00±1.05比12.60±1.65,F = 200.275,P < 0.001;淀粉酶水平：（452.21±101.68）mU/ml、（570.18±148.47） mU/ml比（972.77±204.29） mU/ml,F = 143.245,P < 0.001],同时受损胰腺组织内RIPK1、RIPK3、MLKL表达下调、Caspase-8表达升高（F = 179.905,P < 0.001）。 结论BMSCs可能通过抑制坏死性凋亡通路活化来修复SAP。     

影响急性重症胰腺炎患者死亡的危险因素分析

目的:分析影响急性重症胰腺炎患者死亡的危险因素,为临床防治提供依据。方法:回顾性分析我院2014年11月至2018年10月收治的101例急性重症胰腺炎患者临床资料,根据其治疗结局将其分为生存组(好转出院)82例和死亡组(住院期间死亡)19例,分析影响急性重症胰腺炎患者死亡的危险因素。结果:单因素分析显示:死亡组Ranson评分、急性生理与慢性健康评分(APACHE-II)、CT严重指数(CTSI)、病因、血钙(Ca)、血清白蛋白(ALB)、血糖、血肌酐(Cr)、血尿素氮(BUN)、谷草转氨酶(AST)、上消化道出血发生率、胸腔积液发生率、脓毒血症发生率、休克发生率、多器官功能衰竭发生率与生存组比较差异均有统计学意义(P0.05)。多因素logistic回归分析显示:APACHE-II评分、血糖、Cr、BUN、脓毒血症、休克、多器官功能衰竭是急性重症胰腺炎患者死亡独立危险因素(P0.05),Ca、ALB是其保护因素(P0.05)。结论:影响急性重症胰腺炎患者死亡危险因素包括APACHE-II评分、FPG、Cr、BUN、AST、脓毒血症、休克、多器官功能衰竭,保护因素包括Ca、ALB。     

Pancreatic acinar cells-derived cyclophilin A promotes pancreatic damage by activating NF-κB pathway in experimental pancreatitis

Inflammation triggered by necrotic acinar cells contributes to the pathophysiology of acute pancreatitis (AP), but its precise mechanism remains unclear. Recent studies have shown that Cyclophilin A (CypA) released from necrotic cells is involved in the pathogenesis of several inflammatory diseases. We therefore investigated the role of CypA in experimental AP induced by administration of sodium taurocholate (STC). CypA was markedly upregulated and widely expressed in disrupted acinar cells, infiltrated inflammatory cells, and tubular complexes. In vitro, it was released from damaged acinar cells by cholecystokinin (CCK) induction. rCypA (recombinant CypA) aggravated CCK-induced acinar cell necrosis, promoted nuclear factor (NF)-κB p65 activation, and increased cytokine production. In conclusion, CypA promotes pancreatic damage by upregulating expression of inflammatory cytokines of acinar cells via the NF-κB pathway.     

Spectrum and distribution of CFTR gene mutations in asthma and chronic pancreatitis cases of North Indian population

Background

Cystic fibrosis transmembrane conductance regulator (CFTR) gene accounts for an autosomal recessive condition called cystic fibrosis (CF). In the Indian subcontinent, CF and its related diseases are under-diagnosed by the medical community due to poor knowledge of the disease and its confounding diagnosis, and also due to poor medical facilities available for these patients, thus causing an increased infant mortality rate with a low life expectancy in general. The aim of the study was to document the spectrum and distribution of CFTR mutations in controls, asthma and chronic pancreatitis cases of North India.

Methods

A total of 800 subjects including 400 controls, 250 asthma cases and150 chronic pancreatitis cases were analyzed for 6 mutations (F508del, G542X, G551D, R117H, W1282X, and S549N) and IVS8 Tn polymorphism.

Results

Out of 800 subjects, 18% [asthma — 24% (n = 250), CP — 29.33% (n = 150) cases and controls — 9.3% (n = 400)] were positive for heterozygous mutation, 0.8% of the (n = 250) asthmatic cases (n = 250) were homozygous for IVS8 T5 polymorphism while no subjects were found positive for W1282X mutation. T5 polymorphism was more common in asthmatic cases while F508del mutation in chronic pancreatitis cases. The carrier frequency of F508del, G542X, G551D, R117H, S549N and T5 was 0.015, 0.025, 0.02, 0.005, 0.005, and 0.022 respectively. The cumulative carrier frequency was 0.093.

Conclusion

CFTR mutations were underestimated in Indian population. The present study will serve in establishment of genetic screening and prenatal setup for Indian population.