Rapid transformation of branched pancreatic duct-derived intraductal tubulopapillary neoplasm into an invasive carcinoma: A case report

BACKGROUND Intraductal tubulopapillary neoplasm(ITPN)is a rare disease accounting for approximately 3%of all intraductal pancreatic tumors,with intraductal papillary mucinous neoplasm(IPMN)being one of the most common differential diagnoses.Both ITPN and IPMN display slow growth.A branched pancreatic duct type is commonly observed in IPMN,whereas ITPN derived from the branched pancreatic duct has been reported in a limited number of cases;hence,its pathogenesis remains unclear.CASE SUMMARY Here,we present the case of a patient with ITPN localized in a branched pancreatic duct,with poorly controlled irritable bowel syndrome.A contrastenhanced computed tomography scan of the abdomen incidentally revealed a 5-mm oligemic nodule-like change in the body of the pancreas.Endoscopic ultrasound(EUS)indicated a 10-mm hypoechoic mass without any cystic structures that had grown within 2 mo.EUS-guided fine needle aspiration was performed for definitive diagnosis,and the findings suggested ductal papillary carcinoma.Distal pancreatectomy was performed,and the tumor was pathologically diagnosed as ITPN with an invasive cancerous component,pT3N1aM0,pStage IIB(International Cancer Control,8^(th) edition).The patient underwent treatment with postoperative adjuvant chemotherapy(S-1 monotherapy);however,relapse was observed 1 year and 10 mo after surgical resection,and subsequent treatment involving a combination of chemotherapy and radiotherapy was administered.Maintenance therapy has since facilitated a stable disease state.CONCLUSION Regardless of the microscopic size of the neoplasm,early diagnosis of ITPN with EUS-guided fine needle aspiration and surgical resection are crucial.

Advantageous tactics with certain probiotics for the treatment of graft-versus-host-disease after hematopoietic stem cell transplantation

Hematopoietic stem cell transplantation(HSCT)becomes a standard form of cellular therapy for patients with malignant diseases.HSCT is the first-choice of immunotherapy,although HSCT can be associated with many complications such as graft-versus-host disease(GVHD)which is a major cause of morbidity and mortality after allogeneic HSCT.It has been shown that certain gut microbiota could exert protective and/or regenerative immunomodulatory effects by the production of short-chain fatty acids(SCFAs)such as butyrate in the experimental models of GVHD after allogeneic HSCT.Loss of gut commensal bacteria which can produce SCFAs may worsen dysbiosis,increasing the risk of GVHD.Expression of G-protein coupled receptors such as GPR41 seems to be upre-gulated in the presence of commensal bacteria,which might be associated with the biology of regulatory T cells(Tregs).Treg cells are a suppressive subset of CD4 positive T lymphocytes implicated in the prevention of GVHD after allogeneic HSCT.Here,we discuss the current findings of the relationship between the modification of gut microbiota and the GVHD-related immunity,which suggested that tactics with certain probiotics for the beneficial symbiosis in gut-immune axis might lead to the elevation of safety in the allogeneic HSCT.

Efficacy of probiotics on the modulation of gut microbiota in the treatment of diabetic nephropathy

Diabetic nephropathy(DN)is a major cause of end-stage renal disease,and therapeutic options for preventing its progression are insufficient.The number of patients with DN has been increasing in Asian countries because of westernization of dietary lifestyle,which may be associated with the following changes in gut microbiota.Alterations in the gut microbiota composition can lead to an imbalanced gastrointestinal environment that promotes abnormal production of metabolites and/or inflammatory status.Functional microenvironments of the gut could be changed in the different stages of DN.In particular,altered levels of short chain fatty acids,D-amino acids,and reactive oxygen species biosynthesis in the gut have been shown to be relevant to the pathogenesis of the DN.So far,evidence suggests that the gut microbiota may play a key role in determining networks in the development of DN.Interventions directing the gut microbiota deserve further investigation as a new protective therapy in DN.In this review,we discuss the potential roles of the gut microbiota and future perspectives in the protection and/or treatment of kidneys.

Neuroprotection by dipeptidyl-peptidase-4 inhibitors and glucagonlike peptide-1 analogs via the modulation of AKT-signaling pathway in Alzheimer’s disease

Alzheimer’s disease(AD)is the most common reason for progressive dementia in the elderly.It has been shown that disorders of the mammalian/mechanistic target of rapamycin(mTOR)signaling pathways are related to the AD.On the other hand,diabetes mellitus(DM)is a risk factor for the cognitive dysfunction.The pathogenesis of the neuronal impairment caused by diabetic hyperglycemia is intricate,which contains neuro-inflammation and/or neurodegeneration and dementia.Glucagon-like peptide-1(GLP1)is interesting as a possible link between metabolism and brain impairment.Modulation of GLP1 activity can influence amyloid-beta peptide aggregation via the phosphoinositide-3 kinase/AKT/mTOR signaling pathway in AD.The GLP1 receptor agonists have been shown to have favorable actions on the brain such as the improvement of neurological deficit.They might also exert a beneficial effect with refining learning and memory on the cognitive impairment induced by diabetes.Recent experimental and clinical evidence indicates that dipeptidyl-peptidase-4(DPP4)inhibitors,being currently used for DM therapy,may also be effective for AD treatment.The DPP-4 inhibitors have demonstrated neuroprotection and cognitive improvements in animal models.Although further studies for mTOR,GLP1,and DPP4 signaling pathways in humans would be intensively required,they seem to be a promising approach for innovative AD-treatments.We would like to review the characteristics of AD pathogenesis,the key roles of mTOR in AD and the preventive and/or therapeutic suggestions of directing the mTOR signaling pathway.

By using either endogenous or transplanted stem cells,which could you prefer for neural regeneration？

Neural regeneration by stem cells transplantation：Tissue regeneration and homeostasis are principally dependent on tissue stem cells which possess abilities of self-renewal and differentiation into multidirectional specialized cell types.In general,stem cells are critical for normal tissue renewal as well as repair after tissue injury.For example,mesenchymal stromal cells and endothelial progenitor cells identified in bone marrow could.

Promising role of D-amino acids in irritable bowel syndrome

Irritable bowel syndrome(IBS)is an important health care concern.Alterations in the microbiota of the gut-brain axis may be linked to the pathophysiology of IBS.Some dietary intake could contribute to produce various metabolites including Damino acids by the fermentation by the gut microbiota.D-amino acids are the enantiomeric counterparts of L-amino acids,in general,which could play key roles in cellular physiological processes against various oxidative stresses.Therefore,the presence of D-amino acids has been shown to be linked to the protection of several organs in the body.In particular,the gut microbiota could play significant roles in the stability of emotion via the action of D-amino acids.Here,we would like to shed light on the roles of D-amino acids,which could be used for the treatment of IBS.

Secretome-microRNA and anti-proliferative APRO family proteins as cancer prevention and stem cell research strategies

Stemness of cancer cells contains limitless self-renewal proliferation.For the purpose of proliferation,secretome might exert its effects via the paracrine signaling.Specific microRNAs enclosed in the secretome of cancer stem cells could regulate the expression of anti-proliferative APRO family proteins.The biological functions of APRO family proteins seems to be quite intricate,however,which might be a key modulator of microRNAs,then could regulate the proliferation of cancer cells.In addition to affecting proliferation/differentiation during cellular development,APRO family proteins might also play an imperious role on keeping homeostasis in healthy stem cells under a physiological condition.Therefore,relationship between the microRNAs and the APRO family proteins has attracted much attention in the field of cancer research and regenerative medicine.Here,we have described the molecular mechanism behind this interplay that have a potential role in the future promising tools with targeting APRO family proteins for the medical applications.