Emodin and baicalein inhibit sodium taurocholate-induced vacuole formation in pancreatic acinar cells

AIM To investigate the effects of combined use of emodin and baicalein(CEB) at the cellular and organism levelsin severe acute pancreatitis(SAP) and explore the underlying mechanism.METHODS SAP was induced by retrograde infusion of 5% sodium taurocholate into the pancreatic duct in 48 male SD rats. Pancreatic histopathology score, serum amylase activity, and levels of tumour necrosis factor alpha(TNf-α), interleukin 6(IL-6), and IL-10 were determined to assess the effects of CEB at 12 h after the surgery. The rat pancreatic acinar cells were isolated from healthy male SD rats using collagenase. The cell viability, cell ultrastructure, intracellular free Ca2+ concentration, and inositol(1,4,5)-trisphosphate receptor(IP3 R) expression were investigated to assess the mechanism of CEB.RESULTS Pancreatic histopathology score(2.07 ± 1.20 vs 6.84 ± 1.13, P < 0.05) and serum amylase activity(2866.2 ± 617.7 vs 5241.3 ± 1410.0, P < 0.05) were significantly decreased in the CEB(three doses) treatment group compared with the SAP group(2.07 ± 1.20 vs 6.84 ± 1.13, P < 0.05). CEB dose-dependently reduced the levels of the pro-inflammatory cytokines IL-6(466.82 ± 48.55 vs 603.50 ± 75.53, P < 0.05) and TNF-α(108.04 ± 16.10 vs 215.56 ± 74.67, P < 0.05) and increased the level of the anti-inflammatory cytokine IL-10(200.96 ± 50.76 vs 54.18 ± 6.07, P < 0.05) compared with those in the SAP group. CEB increased cell viability, inhibited cytosolic Ca2+ concentration, and significantly ameliorated intracellular vacuoles and IP3 m RNA expression compared with those in the SAP group(P < 0.05). There was a trend towards decreased IP3 R protein in the CEB treatment group; however, it did not reach statistical significance(P > 0.05).CONCLUSION These results at the cellular and organism levels reflect a preliminary mechanism of CEB in SAP and indicate that CEB is a suitable approach for SAP treatment.

Calcium signaling of pancreatic acinar cells in the pathogenesis of pancreatitis

Pancreatitis is an increasingly common and sometimes severe disease that lacks a specific therapy.The pathogenesis of pancreatitis is still not well understood.Calcium(Ca2+)is a versatile carrier of signals regulating many aspects of cellular activity and plays a central role in controlling digestive enzyme secretion in pancreatic acinar cells.Ca2+overload is a key early event and is crucial in the pathogenesis of many diseases.In pancreatic acinar cells,pathological Ca2+signaling(stimulated by bile,alcohol metabolites and othercauses)is a key contributor to the initiation of cell injury due to prolonged and global Ca2+elevation that results in trypsin activation,vacuolization and necrosis,all of which are crucial in the development of pancreatitis.Increased release of Ca2+from stores in the intracellular endoplasmic reticulum and/or increased Ca2+entry through the plasma membrane are causes of such cell damage.Failed mitochondrial adenosine triphosphate(ATP)production reduces re-uptake and extrusion of Ca2+by the sarco/endoplasmic reticulum Ca2+-activated ATPase and plasma membrane Ca2+-ATPase pumps,which contribute to Ca2+overload.Current findings have provided further insight into the roles and mechanisms of abnormal pancreatic acinar Ca2+signals in pancreatitis.The lack of available specific treatments is therefore an objective of ongoing research.Research is currently underway to establish the mechanisms and interactions of Ca2+signals in the pathogenesis of pancreatitis.

Ghrelin inhibits IKKβ/NF-κB activation and reduces pro-inflammatory cytokine production in pancreatic acinar AR42J cells treated with cerulein

Background: Previous studies have provided conflicting results regarding whether the serum ghrelin concentration can reflect the severity of acute pancreatitis(AP). The present study examined the correlation between the serum ghrelin concentration and AP severity in animal models and investigated whether altered ghrelin expression in pancreatic acinar cells influences IKK β/NF-κ B signaling and pro-inflammatory cytokine production. Methods: Mild or severe AP was induced in rats by intraperitoneal injection of cerulein or retrograde cholangiopancreatic duct injection of sodium taurocholate, respectively. After successful model induction, serum ghrelin, tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) concentrations were determined by enzyme-linked immunosorbent assay, and IKK β/NF-κ B activation was assessed by immunohistochemistry. Subsequently, stable overexpression or knockdown of ghrelin in AR42 J cells was achieved by lentiviral transfection. After transfected cells and control cells were treated with cerulein for 24 h, the TNF-αand IL-1 β levels in the supernatants were determined by enzyme-linked immunosorbent assay, and the expression levels of p-p65, IKK β, and p-IKK β were detected by Western blotting. Results: In rat AP models, AP severity was correlated with increased IKK β/NF-κ B activation, proinflammatory cytokine production, and ghrelin secretion. The levels of pro-inflammatory cytokines TNF-αand IL-1 β as well as IKK β/NF-κ B signaling activity were increased upon knockdown of ghrelin in the AP acinar cell model and decreased with ghrelin overexpression. Conclusions: Serum ghrelin is related to the severity of AP. Ghrelin may play a protective role in the pathogenesis of AP by inhibiting the pro-inflammatory cytokines and the activation of the IKK β/NF-κ B signaling pathway.

Glucocorticoid receptor regulates expression of microRNA-22 and downstream signaling pathway in apoptosis of pancreatic acinar cells

AIM To elucidate the underlying mechanism that microRNA-22(miR-22) promotes the apoptosis of rat pancreatic acinar cells(AR42 J) and the elements that regulate the expression of miR-22.METHODS One hundred nanomoles per liter of caerulein(Cae)was administrated to induce the apoptosis of AR42 J cells and the apoptosis rate was detected by flow cytometry analysis. An amylase assay kit was used to measure the amylase expression level in the supernatant. Quantitative real-time PCR(qRT-PCR)was adopted to measure miR-22 expression. We used online tools to predict the potential transcription promoter of miR-22 and the binding sites, which was further identified by using luciferase reporter analysis,chromatin immunoprecipitation(ChIP) and ChIPqP CR assays. Then, a mimic of miR-22, Nr3 c1 plasmid encoding the glucocorticoid receptor(GR), and siNr3 c1 were used to transfect AR42 J cells, respectively.The mRNA expression of miR-22, Nr3 c1, and Erb-b2 receptor tyrosine kinase 3(ErbB3) was confirmed by qRT-PCR and the apoptosis rate of AR42 J cells was detected by flow cytometry analysis. Western blot was used to detect the expression of ErbB3, GR, PI3 k, PI3 kp85α, Akt, p-Akt, Bad, Bax, Bcl-xl, Bcl-2, and cleaved caspase3.RESULTS After inducing apoptosis of AR42 J cells in vitro, the expression of miR-22 was significantly increased by2.20 ± 0.26 and 4.19 ± 0.54 times, respectively, at3 h and 6 h in comparison with the control group.As revealed by qRT-PCR assay, the expression of miR-22 was 78.25 ± 6.61 times higher in the miR-22 mimic group relative to the miRNA control group,accompanied with an obviously increased acinar cell apoptosis rate(32.53 ± 1.15 vs 18.07 ± 0.89, P =0.0006). The upregulation of miR-22 could suppress its target gene, ErbB3, and the phosphorylation of PI3 k and Akt. Furthermore, we predicted the potential transcription promoter of miR-22 and the binding sites using online tools. Luciferase reporter analysis and sitedirected mutagenesis indicated that the binding site(GACAGCCATGTACA) of the GR, which is encoded by the Nr3 c1 gene. Downregulation of the expression of GR could upregulate the expression of miR-22, which further promoted the apoptosis of AR42 J cells.CONCLUSION GR transcriptionally represses the expression of miR-22,which further promotes the apoptosis of pancreatic acinar cells by downregulating the downstream signaling pathway.

Rare ROS1-CENPW gene in pancreatic acinar cell carcinoma and the effect of crizotinib plus AG chemotherapy:A case report

BACKGROUND This is the first report of an ROS1-CENPW fusion gene in pancreatic malignancies.CASE SUMMARY A 77-year-old woman with a pancreatic tumor and multiple liver metastases was admitted to our hospital.Genetic testing revealed the presence of the ROS1-CENPW fusion gene,a rare fusion gene that has not been previously reported in the field of pancreatic cancer.The patient received crizotinib plus AG(albumin paclitaxel plus gemcitabine)chemotherapy.After treatment,the patient’s condition stabilized,and her prognosis was good.CONCLUSION The ROS1-CENPW gene treatment regimen used in this case is an excellent treatment option that provides new hope for patients with advanced pancreatic cancer and similar genetic mutations.To date,owing to the rarity of the ROS1-CENPW fusion gene,our team has encountered only a single case.Therefore,the efficacy of crizotinib plus AG chemotherapy in patients with pancreatic acinar cell carcinoma harboring the ROS1-CENPW fusion gene requires further validation.

Involvement of M3 Cholinergic Receptor Signal Transduction Pathway in Regulation of the Expression of Chemokine MOB-1, MCP-1 Genes in Pancreatic Acinar Cells

Whether M3 cholinergic receptor signal transduction pathway is involved in regulation of the activation of NF-κB and the expression of chemokine MOB-1, MCP-1genes in pancreatic acinar cells was investigated. Rat pancreatic acinar cells were isolated, cultured and treated with carbachol, atropine and PDTC in vitro. The MOB-1 and MCP-1 mRNA expression was detected by using RT-PCR. The activation of NF-κB was monitored by using electrophoretic mobility shift assay. The results showed that as compared with control group, M3 cholinergic receptor agonist (10 -3 mol/L, 10 -4 mol/L carbachol) could induce a concentration-dependent and time-dependent increase in the expression of MOB-1, MCP-1 mRNA in pancreatic acinar cells. After treatment with 10 -3 mol/L carbachol for 2 h, the expression of MOB-1, MCP-1 mRNA was strongest. The activity of NF-κB in pancreatic acinar cells was significantly increased (P<0.01) after treated with M3 cholinergic receptor agonist (10 -3 mol/L carbachol) in vitro for 30 min. Either M3 cholinergic receptor antagonist (10 -5 mol/L atropine) or NF-κB inhibitor (10 -2 mol/L PDTC) could obviously inhibit the activation of NF-κB and the chemokine MOB-1, MCP-1 mRNA expression induced by carbachol (P<0.05). This inhibitory effect was significantly increased by atropine plus PDTC (P<0.01). The results of these studies indicated that M3 cholinergic receptor signal transduction pathway was likely involved in regulation of the expression of chemokine MOB-1 and MCP-1genes in pancreatic acinar cells in vitro through the activation of NF-κB.

Study of nennatolysosomes in mouse hepatocytes and pancreatic exocrine acinar cells

Acid phosphatase(ACPase)-positive nematolysosomes in mouse hepatocytes and thepancreatic exocrine acinar cells were studied with ultracytoehemical method.The nematolyso-somes were 2～8μm in length,0.1～0.3μm in diameter.Some branched and some did notbranch,and most of them winded through the organelles.

Comparison of pancreatic acinar cell carcinoma and adenocarcinoma using multidetector-row computed tomography

AIM:To distinguish acinar cell carcinoma(ACC)from pancreatic adenocarcinoma(AC)by comparing their computed tomography findings.METHODS:Patients with ACC and AC were identified on the basis of results obtained using surgically resected pancreatectomy specimens.The preoperative computer tomographic images of 6 acinar cell carcinoma patients and 67 pancreatic adenocarcinoma patients in 4 phases(non-contrast,arterial,portal venous,and delayed phase)were compared.The scan delay times were 40,70,and 120 s for each contrast-enhanced phase.The visual pattern,tomographic attenuation value,and time attenuation curve were assessed and compared between AC and ACC cases using the 2test,Wilcoxon signed-rank test,and Mann Whitney U test.RESULTS:The adenocarcinomas tended to be hypodense in all 4 phases.The acinar cell carcinomas also tended to be hypodense in the 3 contrast-enhancedphases,although their computed tomographic attenuation values were higher.Further,5 of the 6 acinar cell carcinomas(83%)were isodense in the non-contrast phase.The time attenuation curve of the adenocarcinomas showed a gradual increase through the 4 phases,and all adenocarcinomas showed peak enhancement during the delayed phase.The time attenuation curve of the acinar cell carcinomas showed peak enhancement during the portal venous phase in 4 cases and during the arterial phase in 2 cases.None of the 6 acinar cell carcinomas showed peak enhancement during the delayed phase.CONCLUSION:The tumor density in the non-contrast phase and time attenuation curve pattern clearly differ between acinar cell carcinomas and adenocarcinomas,and multidetector-row computed tomography can thus distinguish these tumors.

Inflammatory role of the acinar cells during acute pancreatitis

Pancreatic acinar cells are secretory cells whose main function is to synthesize, store and f inally release digestive enzymes into the duodenum. However, in response to noxious stimuli, acinar cells behave like real inflammatory cells because of their ability to activate signalling transduction pathways involved in the expression of inflammatory mediators. Mediated by the kinase cascade, activation of Nuclear factor-κB, Activating factor-1 and Signal transducers and activators of transcription transcription factors has been demonstrated in acinar cells, resulting in overexpression of inflammatory genes. In turn, kinase activity is down-regulated by protein phosphatases and the f inal balance between kinase and phosphatase activity will determine the capability of the acinar cells to produce inflammatory factors. The kinase/ phosphatase pair is a redox-sensitive system in which kinase activation overwhelms phosphatase activity under oxidant conditions. Thus, the oxidative stress developed within acinar cells at early stages of acute pancreatitis triggers the activation of signalling pathways involved in the up-regulation of cytokines, chemokines and adhesion molecules. In this way, acinar cells trigger the release of the f irst inflammatory signals which can mediate the activation and recruitment of circulating inflammatorycells into the injured pancreas. Accordingly, the role of acinar cells as promoters of the inflammatory response in acute pancreatitis may be considered. This concept leads to amplifying the focus from leukocyte to acinar cells themselves, to explain the local inflammation in early pancreatitis.

Therapeutic potential of targeting acinar cell reprogramming in pancreatic cancer

Pancreatic ductal adenocarcinoma(PDAC) is a common pancreatic cancer and the fourth leading cause of cancer death in the United States. Treating this life-threatening disease remains challenging due to the lack of effective prognosis, diagnosis and therapy. Apart from pancreatic duct cells, acinar cells may also be the origin of PDAC. During pancreatitis or combined with activating KRasG12 D mutation, acinar cells lose their cellular identity and undergo a transdifferentiation process called acinarto-ductal-metaplasia(ADM), forming duct cells which may then transform into pancreatic intraepithelial neoplasia(Pan IN) and eventually PDAC. During ADM, the activation of mitogen-activated protein kinases, Wnt, Notch and phosphatidylinositide 3-kinases/Akt signaling inhibits the transcription of acinar-specific genes, including Mist and amylase, but promotes the expression of ductal genes, such as cytokeratin-19. Inhibition of this transdifferentiation process hinders the development of Pan IN and PDAC. In addition, the transdifferentiated cells regain acinar identity, indicating ADM may be a reversible process. This provides a new therapeutic direction in treating PDAC through cancer reprogramming. Many studies have already demonstrated the success of switching Pan IN/PDAC back to normal cells through the use of PD325901, the expression of E47, and the knockdown of Dickkopf-3. In this review, we discuss the signaling pathways involved in ADM and the therapeutic potential of targeting reprogramming in order to treat PDAC.

Pancreatic acinar cell carcinoma: A review on molecular profiling of patient tumors

Pancreatic carcinomas with acinar differentiation are rare,accounting for 1%-2% of adult pancreatic tumors; they include pancreatic acinar cell carcinoma(PACC),pancreatoblastoma,and carcinomas of mixed differentiation. Patients with PACC have a prognosis better than pancreatic ductal adenocarcinomas but worse than pancreatic neuroendocrine tumors. Reports of overall survival range from 18 to 47 mo. A literature review on PACCs included comprehensive genomic profiling and whole exome sequencing on a series of more than 70 patients as well as other diagnostic studies including immunohistochemistry. Surgical resection of PACC is the preferred treatment for localized and resectable tumors. The efficacy of adjuvant treatment is unclear. Metastatic PACCs are generally not curable and treated with systemic chemotherapy. They are moderately responsive to chemotherapy with different regimens showing various degrees of response in case reports/series. Most of these regimens were developed to treat patients with pancreatic ductal adenocarcinomas or colorectal adenocarcinomas. Review of PACC's molecular profiling showed a number of gene alterations such as: SMAD4,BRAF,BRCA2,TP53,RB1,MEN1,JAK-1,BRCA-1,BRCA-2,and DNA mismatch repair abnormalities. PACCs had multiple somatic mutations with some targetable with available drugs. Therefore,molecular profiling of PACC should be an option for patients with refractory PACC.

EGFR amplification induces sensitivity to antiEGFR therapy in pancreatic acinar cell carcinoma

Pancreatic acinar cell carcinoma(PACC) is a rare cancer. When the tumor is metastatic, few therapeutic options are available. Precision medicine using next-generation sequencing is defined by the administration of drugs based on the tumor genetic mutations. The usage of precision medicine for finding new therapeutic options for rare cancers is an emerging field. We have reported here the case of a patient bearing a multitreated metastatic PACC. This patient underwent somatic and constitutional exome analyses. The analyses revealed in the liver metastasis an amplification of the EGFR gene. Accordingly, the patient was treated with off-label usage of panitumumab. We observed rapid response with necrosis of the liver metastasis, while no efficacy was observed in the primary tumor. An exome analysis of the primary tumor revealed amplification of HER2 and MET with EGFR amplification. Such amplifications are known as a resistance mechanism to anti EGFR therapy. Our results suggest that exome analysis may be helpful to highlight targets in rare cancers, such as PACC. EGFR amplification in this pathology should be determined and could be used as a biomarker to propose anti EGFR therapy.

Nicotine as a mitogenic stimulus for pancreatic acinar cell proliferation

Cell proliferation is an important process in life for growth of normal and cancer cells. The signal transduction pathways activated during this process are strictly regulated. This editorial focuses on the role of nicotine, a mitogen, in the induction of signaling pathways resulting in proliferation of pancreatic tumor cells and compares these events with those in normal acinar cells isolated from the rat pancreas. The data shows striking similarities between these two cellular systems. In addition, the editorial reviews very recent literature of the contribution of MAPK signaling in cell lines associated with human diseases. A prospective cellular model of nicotine induced activation of MAPK cascade is presented.

Relationship between Carbachol Hyperstimulation-Induced Pancreatic Acinar Cellular Injury and Trypsinogen or NF-κB Activation in Rats in vitro

The relationship between M3 cholinergic receptor agonist （carbachol） hyperstimulationinduced pancreatic acinar cellular injury and trypsinogen activation or NF-κB activation in rats was studied in vitro. Rat pancreatic acinar ceils were isolated, cultured and treated with carbachol, the active protease inhibitor （pefabloc）, and NF-κB inhibitor （PDTC） in vitro. Intracellular trypsin activity was measured by using a fluorogenic substrate. The cellular injury was evaluated by measuring the leakage of LDH from pancreatic acinar ceils. The results showed that as compared with control group, 10-3 mol/L carbachol induced a significant increase of the intracellular trypsin activity and the leakage of LDH from pancreatic acinar cells. Pretreatment with 2 mmol/L pefabloc could significantly decrease the activity of trypsin and the leakage of LDH from pancreatic acinar cells （P〈0. 01） following the treatment with a high concentration of carbachol （10^-3 mol/L） in vitro. The addition of 10^-2mol/L PDTC didn＇t result in a significant decrease in the activity of trypsin and the leakage of LDH from pancreatic acinar cells treated with a high concentration of carbachol （10^-3 mol/L） in vitro （P〉0. 05）. It was concluded that intracellular trypsinogen activation is likely involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro. NF-κB activation may not be involved in pancreatic acinar cellular injury induced by carbachol hyperstimulation in vitro.

Pancreatic panniculitis and elevated serum lipase in metastasized acinar cell carcinoma of the pancreas: A case report and review of literature

BACKGROUND Pancreatic panniculitis is an extremely rare condition associated with different underlying pancreatic disorders and characterized by subcutaneous fat necrosis induced by elevated serum lipase levels.These lesions usually affect the lower extremities and may precede abdominal symptoms of pancreatic disease.Acinar cell carcinoma(ACC)of the pancreas is a rare pancreatic neoplasm,accounting for only 1%-2%of pancreatic tumors in adults.We present the case of a 72-year-old man with ACC of the pancreatic head and synchronous liver metastases.Both the primary tumor and liver metastases were resected.Serum lipase was elevated before surgery and decreased to normal postoperatively.Rising serum lipase levels at follow-up led to the diagnosis of hepatic recurrence.This disease progression was then accompanied by pancreatic panniculitis,with subcutaneous fat necrosis and acute arthritis.To the best of our knowledge,only 4 cases have been reported in the literature and each showed a similar association of serum lipase levels with pancreatic panniculitis and progression of ACC.CONCLUSION Clinical symptoms and progression of ACC may correlate with serum lipase levels,suggesting potential usefulness as a follow-up biomarker.

Synchronous concomitant pancreatic acinar cell carcin and gastric adenocarcinoma:A case report and review of literature

BACKGROUND Multiple primary malignant tumors are two or more malignancies in an individual without any relationship between the neoplasms.In recent years,an increasing number of cases have been reported.However,concomitant primary gastric and pancreatic cancer reported a relatively small incidence,involving no pancreatic acinar cell carcinoma reports.Here,we present the first case of concomitant pancreatic acinar cell carcinoma and gastric adenocarcinoma.CASE SUMMARY A 69-year-old male presented to our department with a history of vomiting,epigastric pain,and weight loss.Imaging revealed space-occupying lesions in the stomach and the tail of the pancreas,respectively.The patient underwent laparo-scopic radical gastrectomy and pancreatectomy simultaneously.The pathologies of surgical specimens were completely different:The resected gastric specimen was moderate to poorly differentiated adenocarcinoma,whereas the pancreatic tumor was consistent with acinar cell carcinoma.The patient was treated with six cycles of oxaliplatin and S-1 chemotherapy.As of March 2021,the patient was healthy without any recurrence or metastasis.After thoroughly reviewing the literature on simultaneous pancreatic and gastric cancers at home and abroad,we discussed the clinical characteristics of these rare synchronous double cancers.Most of the cases had undergone surgery and adjuvant chemotherapy,and all of the cases were pathologically confirmed by the postoperative specimen.CONCLUSION Synchronous pancreatic acinar cells and gastric adenocarcinoma can occur and should be considered when tumors are found in these organs.

lncRNA TUG1靶向调节miR-31-5p对急性胰腺炎小鼠炎症反应的影响

目的:探讨长链非编码RNA牛磺酸上调基因1(lncRNA TUG1)在急性胰腺炎(AP)中的作用机制。方法:体外培养小鼠胰腺腺泡细胞系(MPC-83),用脂多糖(LPS,10μg/ml)和雨蛙素(Caerulein,100 nmol/L)处理3 h,建立AP模型。实验分为对照组(control组)、AP组、AP+sh-NC组、AP+sh-TUG1组、AP+sh-TUG1+inhibitor-NC组、AP+sh-TUG1+miR-31-5p inhibitor组。实时荧光定量PCR(qRT-PCR)检测细胞中lncRNA TUG1和miR-31-5p表达水平;CCK-8法检测细胞活力;流式细胞术检测细胞凋亡;ELISA检测细胞上清液中IL-1β、肿瘤坏死因子α(TNF-α)水平;双荧光素酶报告基因实验验证lncRNA TUG1和miR-31-5p之间的靶向关系。构建AP小鼠模型,给予相应的干预后,qRT-PCR检测胰腺组织中lncRNA TUG1和miR-31-5p表达水平;试剂盒检测血清中炎症因子IL-1β、TNF-α含量和淀粉酶(AMY)和脂肪酶(Lipase)活性;HE染色观察胰腺组织病理学变化;TUNEL检测胰腺组织中细胞凋亡。结果:在Caerulein和LPS共同处理的MPC-83细胞中lncRNA TUG1水平、细胞凋亡率、IL-1β和TNF-α水平升高,miR-31-5p水平、细胞活力降低(均P<0.05);敲低lncRNA TUG1可上调miR-31-5p,增加细胞活力,降低IL-1β和TNF-α水平,抑制细胞凋亡(均P<0.05);下调miR-31-5p表达可减弱敲低lncRNA TUG1对细胞炎症反应的抑制作用。miR-31-5p是lncRNA TUG1的直接靶标。在体内敲低lncRNA TUG1表达可上调AP小鼠胰腺组织中miR-31-5p表达,降低IL-1β、TNF-α水平,减少细胞凋亡,改善胰腺组织损伤。结论:敲低lncRNA TUG1可能通过上调miR-31-5p表达水平,抑制炎症反应,改善AP。

腺泡细胞钙离子超载与急性胰腺炎关系的研究进展

急性胰腺炎(AP)是消化科的常见的疾病类型之一,大多数患者病情轻微,但约25%的患者会发展为重症胰腺炎,其中重症胰腺炎的致死率则高达30%~50%。国内诸多对AP病因病机的基础研究显示,使用雨蛙素法、无胆盐乙硫氨酸食物诱导法、胆胰管逆行牛黄胆酸钠注射法诱导的AP动物模型中腺泡细胞内钙离子浓度均持续增高,进而引起胞内钙离子依赖性的酶原颗粒提前活化、空泡形成最终导致细胞凋亡,以上结论均提示腺泡细胞钙离子超载在AP的发生发展中起到至关重要的作用,而针对AP的治疗目前临床上缺乏高效且具有针对性的靶向药物,故探索维持细胞内钙稳态的机制及腺泡细胞钙超载所引起的病理过程,可为研究AP的直接靶向治疗药物提供新思路。该文就细胞内钙稳态与调控、腺泡细胞钙超载的发生、Ca2+超载在AP发病机制中的作用、腺泡细胞Ca2+超载的临床诊治方法的研究进展作一综述。

胰腺腺泡细胞癌伴脾脏侵犯肿瘤破裂出血1例

胰腺腺泡细胞癌(PACC)是一种临床上罕见的胰腺恶性肿瘤,缺乏特异性临床表现及肿瘤标志物,检查发现胰腺占位应考虑到PACC的可能性,临床确诊需术后活组织病理学检查明确,早期积极手术并辅以术后综合性治疗可明显改善患者预后。现报道怒江州人民医院收治的1例术后病理学检查明确PACC伴脾脏侵犯肿瘤破裂出血行开放胰腺体尾部切除+全脾脏切除+淋巴结清扫术的患者临床病例资料并结合相关文献对本病的发病机制、临床表现、诊断、治疗、预后等进行讨论分析,以提高对该疾病的认识。

Acinar cell injury induced by inadequate unfolded protein response in acute pancreatitis

Acute pancreatitis (AP) is an inflammatory disorder of pancreatic tissue initiated in injured acinar cells. Severe AP remains a significant challenge due to the lack of effective treatment. The widely-accepted autodigestion theory of AP is now facing challenges, since inhibiting protease activation has negligible effectiveness for AP treatment despite numerous efforts. Furthermore, accumulating evidence supports a new concept that malfunction of a self-protective mechanism, the unfolded protein response(UPR), is the driving force behind the pathogenesis of AP. The UPR is induced by endoplasmic reticulum(ER) stress, a disturbance frequently found in acinar cells, to prevent the aggravation of ER stress that can otherwise lead to cell injury. In addition, the UPR's signaling pathways control NFκB activation and autophagy flux, and these dysregulations cause acinar cell inflammatory injury in AP, but with poorly understood mechanisms. We therefore summarize the protective role of the UPR in AP, propose mechanistic models of how inadequate UPR could promote NFκB's pro-inflammatory activity and impair autophagy's protective function in acinar cells, and discuss its relevance to current AP treatment. We hope that insight provided in this review will help facilitate the research and management of AP.