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Mortality trends for acute pancreatitis during the COVID-19 pandemic in the US. 美国 COVID-19 大流行期间急性胰腺炎的死亡率趋势。
IF 2.9 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002381
Camilla Mattiuzzi,Giuseppe Lippi
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引用次数: 0
Tumor immune microenvironment promotes cachexia in pancreatic cancer. 肿瘤免疫微环境促进胰腺癌恶病质的形成
IF 2.9 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002386
Suresh T Chari
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引用次数: 0
Increased PRIM2 expression associated with poor-prognosis in patients with pancreatic ductal adenocarcinoma. 胰腺导管腺癌患者的 PRIM2 表达增加与预后不良有关。
IF 2.9 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002387
Jingyang Yin,Shixiang Guo,Jiali Yang,Renpei Xia,Huaizhi Wang
OBJECTIVESTo explore the association between PRIM2 expression and prognosis of patients with pancreatic ductal adenocarcinoma (PDAC) from multi clinic centers.METHODSSamples from PDAC patients were collected and processed to tissue microarray (TMA). PRIM2 expression was detected by immunohistochemistry (IHC) of in 127 enrolled PDAC patients, which underwent surgical resection from January 2012 to December 2018, with complete follow-up, were enrolled and grouped by PRIM2 stain level into two groups. The expression differences, the association to clinicopathologic features and the survival were evaluated by the groups. Data of RNA/protein expression and clinical features from public databases were used for validation.RESULTSPRIM2 was highly expressed in PDAC patients and associated with poor-prognosis in patients with PDAC. Association was found between increased PRIM2 levels and pathology grade (p = 0.050). Moreover, in multivariate analysis of survival, the highly expression of PRIM2 was identified as an independent risk factor for poor survival (HR1.78, p = 0.031). Analysis on public databases validated above results.CONCLUSIONSHigh expression of PRIM2 associated with poor prognosis in PDAC patients, PRIM2 could be used as an independent risk indicator.
目的探讨来自多个临床中心的胰腺导管腺癌(PDAC)患者的PRIM2表达与预后之间的关联。方法收集PDAC患者的样本并处理成组织芯片(TMA)。通过免疫组化(IHC)检测2012年1月至2018年12月期间接受手术切除、随访完整的127例PDAC患者的PRIM2表达,并按PRIM2染色水平分为两组。各组患者的表达差异、与临床病理特征的关联以及生存率均接受了评估。结果PRIM2在PDAC患者中高表达,与PDAC患者的不良预后相关。PRIM2水平升高与病理分级之间存在关联(p = 0.050)。此外,在生存率的多变量分析中,PRIM2 的高表达被确定为生存率低的独立风险因素(HR1.78,p = 0.031)。结论PRIM2的高表达与PDAC患者的不良预后有关,PRIM2可作为一个独立的风险指标。
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引用次数: 0
Characterization of Human Pancreatic Islet Cells using a Single-Cell Western Blot Platform. 利用单细胞 Western Blot 平台表征人类胰岛细胞
IF 2.9 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002385
Gal Lenz,Lynn Miao,Ayelet Lenz,Jacob Mares,Janine Quijano,Heather N Zook,Hirotake Komatsu,Pablo Garcia,Kevin Ferreri,Hsun Teresa Ku,Fouad Kandeel
OBJECTIVEIslet transplantation is an effective treatment for type 1 diabetes. However, transplant success depends on quick islet assessment because islets deteriorate 2-3 days after isolation. A new tool, single-cell Western blot (scWestern), offers results within one day. In this study, we aimed to test the suitability of scWestern to detect protein markers for beta (insulin), alpha (glucagon), and delta (somatostatin) cells, the three major endocrine cell types in islets.METHODSWe characterized the antibody specificity, signal intensity, and cell identification on the scWestern platform, and then compared the islet cell composition analysis between scWestern and immunohistochemistry performed by the Integrated Islet Distribution Program (IIDP).RESULTSIslet cell composition is comparable for alpha and beta cells, but not delta cells. Protein expression levels of insulin, glucagon, and somatostatin in individual islet cells varied greatly, highlighting cell type heterogeneity. Surprisingly, scWestern revealed double-hormonal cells (~1%), co-expressing insulin and somatostatin or insulin and glucagon, in non-diabetic and non-obese adult human islets, which was confirmed by confocal immunofluorescence microscopy.CONCLUSIONSThese results demonstrate that each alpha, beta, and delta cells express varying levels of peptide hormones, and a small subpopulation co-expresses double hormones in normal human islets. The scWestern platform will enable timely assessment of beta cell mass in isolated islets before clinical transplantation.
目的胰岛移植是治疗 1 型糖尿病的有效方法。然而,移植成功与否取决于能否快速评估胰岛,因为胰岛在分离后 2-3 天就会恶化。一种新工具--单细胞 Western 印迹(scWestern)可在一天内得到结果。在本研究中,我们旨在测试单细胞 Western 印迹法是否适合检测胰岛中三种主要内分泌细胞类型--β(胰岛素)、α(胰高血糖素)和δ(体生长抑素)细胞的蛋白质标记物。方法我们对 scWestern 平台上的抗体特异性、信号强度和细胞识别进行了鉴定,然后比较了 scWestern 和综合胰岛分布计划 (IIDP) 免疫组化进行的胰岛细胞组成分析。单个胰岛细胞中胰岛素、胰高血糖素和体生长抑素的蛋白表达水平差异很大,突出表明了细胞类型的异质性。令人惊讶的是,scWestern 发现了双激素细胞(约 1%),在非糖尿病和非肥胖成人胰岛中共同表达胰岛素和体节素或胰岛素和胰高血糖素,共聚焦免疫荧光显微镜证实了这一点。scWestern平台可在临床移植前及时评估离体胰岛中β细胞的数量。
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引用次数: 0
Individualized Pain Treatment in Chronic Pancreatitis (INPAIN): An International, Multicenter, Investigator-initiated, Prospective, Cohort Study. 慢性胰腺炎的个体化疼痛治疗 (INPAIN):一项国际性、多中心、研究者发起的前瞻性队列研究。
IF 2.9 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-12 DOI: 10.1097/mpa.0000000000002388
Rasmus Hagn-Meincke,Ana Dugic,Ankit Agarwal,Anna Evans Phillips,Anna Waage,Dhiraj Yadav,Divya Pillai,Elaina Vivian,Enrique de-Madaria,Imran Khan Niazi,Jeffrey Easler,Jens Brøndum Frøkjær,Julia McNabb-Baltar,Louise Kuhlmann Asferg,Mahya Faghih,Maria Belen Garay Montiel,Mathias Cook,Misbah Unnisa,Paul Tarnasky,Peter Hegyi,Pramod Garg,Rasmus Bach Nedergaard,Robert Edwards,Rupjyoti Talukdar,Shagufta Farheen,Søren Schou Olesen,Soumya Jagannath,Suzette Schmidt,Vikesh Singh,Zoltán Hajnády,Asbjørn Mohr Drewes,
INTRODUCTIONPain is the foremost complication of chronic pancreatitis (CP), affecting about 70% of patients. However, the pathophysiological understanding and management of CP-related pain is complex, likely as patients have diverse "pain phenotypes" responding differently to treatment. This study aims to develop a bedside test panel to identify distinct pain phenotypes, investigate the temporal evolution, and determine whether they can be used to predict treatment response.METHODThe INPAIN study is an international, multi-center, observational, longitudinal cohort study comprised of 4 sub-studies. The studies will prospectively enroll 400 CP patients (50 without pain and 350 with pain) and 50 control subjects, conducting biannual observations for four years. The test panel is comprised of comprehensive subjective and objective assessment parameters. Statistical analysis strategies differ across the sub-studies. A model to predict treatment efficacy will be developed using various machine learning techniques, including an artificial intelligence approach, with internal cross-validation. Trajectories in pain parameters will be characterized by graphical analysis and mixed effect models.DISCUSSIONThe INPAIN study aims to comprehensively understand pain in CP through a test panel developed for routine clinical use. This tool has the potential to personalize treatments, improve clinical practice, enhance patient care, improve quality of life, and minimize treatment side effects.
引言 疼痛是慢性胰腺炎(CP)最主要的并发症,约 70% 的患者会出现疼痛。然而,对 CP 相关疼痛的病理生理学理解和管理却很复杂,这可能是因为患者有不同的 "疼痛表型",对治疗的反应也不尽相同。本研究旨在开发床旁测试面板,以识别不同的疼痛表型,研究其时间演变,并确定它们是否可用于预测治疗反应。 方法 INPAIN 研究是一项国际性、多中心、观察性、纵向队列研究,由 4 项子研究组成。这些研究将前瞻性地招募 400 名 CP 患者(50 名无痛患者和 350 名有痛患者)和 50 名对照组受试者,每半年进行一次观察,为期四年。测试面板由全面的主观和客观评估参数组成。各项子研究的统计分析策略各不相同。将利用各种机器学习技术(包括人工智能方法)开发一个预测疗效的模型,并进行内部交叉验证。疼痛参数的轨迹将通过图形分析和混合效应模型进行描述。该工具有望实现个性化治疗、改善临床实践、加强患者护理、提高生活质量并最大限度地减少治疗副作用。
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引用次数: 0
A Case of Thrombotic Microangiopathy Within Acute Pancreatitis. 一例急性胰腺炎血栓性微血管病。
IF 1.7 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-27 DOI: 10.1097/MPA.0000000000002355
Marwin A Farrugia, Anaïs Darnaude, Elena Santos-Pérez, Eve Gelsi
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引用次数: 0
Exosomes Derived From Cerulein-Stimulated Pancreatic Acinar Cells Mediate Peritoneal Macrophage M1 Polarization and Pyroptosis via an miR-24-3p/MARCH3/NLRP3 Axis in Acute Pancreatitis. 通过 miR-24-3p/MARCH3/NLRP3 轴介导急性胰腺炎中腹膜巨噬细胞 M1 极化和脓毒症的发生
IF 1.7 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-27 DOI: 10.1097/MPA.0000000000002351
Xiao-Ju Su, Yan Chen, Qi-Chen Zhang, Xiao-Bo Peng, Ya-Ping Liu, Lei Wang, Yi-Qi Du

Objectives: Acute pancreatitis (AP) has a high incidence of hospitalizations, morbidity, and mortality worldwide. A growing number of studies on AP pathogenesis are based on cerulein-induced experimental model, which simulates human AP in vivo. It has been demonstrated that both pancreatic acinar cells and peritoneal macrophages are involved in pancreatic inflammation and damage. However, their connection has not been well understood.

Methods: A cerulein-induced AP model was established on the pancreatic acinar cell line AR42J. Rat macrophages were isolated from the peritoneal cavity. The effects of cerulein-induced pancreatic exosomes on the peritoneal macrophage and pancreas in vivo and in vitro were examined. The underlying molecular mechanism was investigated by exploring the regulatory role of downstream molecules.

Results: We found that exosomes derived from cerulein-treated AR42J cells induced rat peritoneal macrophage M1 polarization and pyroptosis. miR-24-3p was upregulated in cerulein-stimulated exosomes, whereas the miR-24-3p inhibitor counteracted the effect of pancreatic exosomes on peritoneal macrophage M1 polarization and pyroptosis. Furthermore, miR-24-3p inhibited March3 expression, whereas MARCH3 mediated NLRP3 ubiquitination in rat peritoneal macrophages, which, in turn, contributed to the apoptosis, reactive oxygen species production, and inflammation in AR42J cells.

Conclusions: Exosomes derived from cerulein-stimulated pancreatic acinar cells mediate peritoneal macrophage M1 polarization and pyroptosis via an miR-24-3p/MARCH3/NLRP3 axis in AP.

目的:急性胰腺炎(AP)在全世界的住院率、发病率和死亡率都很高。越来越多关于急性胰腺炎发病机制的研究都是基于胰岛素诱导的实验模型,该模型模拟了人体急性胰腺炎。研究表明,胰腺尖叶细胞和腹腔巨噬细胞都参与了胰腺炎症和损伤。然而,人们对它们之间的联系还不甚了解:方法:在胰腺尖细胞株 AR42J 上建立了由开塞露素诱导的 AP 模型。从腹腔中分离出大鼠巨噬细胞。研究了caerulein诱导的胰腺外泌体在体内和体外对腹腔巨噬细胞和胰腺的影响。通过探索下游分子的调控作用,研究了其潜在的分子机制:结果:我们发现,来自经caerulein处理的AR42J细胞的外泌体可诱导大鼠腹腔巨噬细胞M1极化和嗜热。此外,miR-24-3p抑制了March3的表达,而MARCH3介导了大鼠腹腔巨噬细胞中NLRP3的泛素化,这反过来又促进了AR42J细胞的凋亡、活性氧的产生和炎症:结论:在AP中,来自caerulein刺激的胰腺尖腺细胞的外泌体通过miR-24-3p/MARCH3/NLRP3轴介导腹腔巨噬细胞M1极化和热凋亡。
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引用次数: 0
Poly (Adp-Ribose) Polymerase-1 (PARP-1) Is a Good Prognostic Marker for Pancreatic/Periampullary Cancers. 聚(ADP-核糖)聚合酶-1(PARP-1)是胰腺癌/髓周癌的良好预后标志物。
IF 1.7 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-09-01 Epub Date: 2024-03-27 DOI: 10.1097/MPA.0000000000002356
Kwangil Yim, Kyung Jin Seo, Jamshid Abdul-Ghafar, Mohammad Rizwan Alam, Kwang Yeol Paik, Yosep Chong, Ok Ran Shin

Background: Periampullary cancer (PAC) is highly aggressive with no effective adjuvant therapy or prognostic markers. Recently, poly (ADP-ribose) polymerase-1 (PARP-1) has emerged as a target in solid cancers, and its relationship with epithelial-mesenchymal transition (EMT) has been observed. However, the relationship between PARP-1 and EMT in PAC has not explored well.

Materials and methods: We assessed the prognostic significance of PARP-1 in 190 PACs patients and correlated it with EMT markers, including FGF8, FGFR4, MMP2, MMP3, Snail, and ZEB1. Immunohistochemistry for PARP-1 and EMT markers was performed using a tissue microarray.

Results: PARP-1 and FGF8 expression were associated with better survival unlike other solid cancers ( P = 0.006 and P = 0.003), and MMP3 and ZEB1 expression were associated with poor prognosis in multivariate and survival analyses ( P = 0.009 and P < 0.001). In addition, PARP-1 is related negatively to Snail but not related with other EMT markers, implying an independent mechanism between PARP-1 and EMT in PACs. PARP-1 and FGF8 are independent good survival markers in PACs unlike other solid cancers.

Conclusions: PARP-1 and FGF8 in PACs could not be related to the EMT pathway but must be rather understood in light of similar cancer-protective roles. Further studies are required on EMT-associated immune markers in PACs.

背景:髓周癌(PAC)具有高度侵袭性,目前尚无有效的辅助治疗或预后标志物。最近,多聚(ADP-核糖)聚合酶-1(PARP-1)已成为实体瘤的靶点,其与上皮-间质转化(EMT)的关系也已被观察到。然而,PARP-1与PAC中EMT的关系尚未得到很好的探讨:方法:我们评估了 190 例 PAC 患者中 PARP1 的预后意义,并将其与 EMT 标志物(包括 FGF8、FGFR4、MMP2、MMP3、Snail 和 ZEB1)相关联。使用组织芯片对PARP-1和EMT标记物进行了免疫组化:结果:与其他实体瘤不同,PARP-1和FGF8的表达与较好的生存率相关(P = 0.006和P = 0.003),而在多变量和生存率分析中,MMP3和ZEB1的表达与不良预后相关(P = 0.009和P < 0.001)。此外,PARP-1与Snail呈负相关,但与其他EMT标记物无关,这意味着PARP-1与PACs中的EMT之间存在独立机制。与其他实体瘤不同,PARP-1和FGF8在PAC中是独立的良好生存标志物:结论:PARP-1和FGF8在PAC中的作用与EMT通路无关,但必须从类似的癌症保护作用角度加以理解。关于PAC中与EMT相关的免疫标记物,还需要进一步研究。
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引用次数: 0
HSP70 promotes pancreatic cancer cell epithelial-mesenchymal transformation and growth via the NF-κB signaling pathway. HSP70 通过 NF-κB 信号通路促进胰腺癌细胞上皮-间质转化和生长。
IF 1.7 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-08-16 DOI: 10.1097/MPA.0000000000002398
Liumei Xiong, Danming Li, Gui Xiao, Sipin Tan, Linfang Xu, Guiliang Wang

Objective: To study the effects of HSP70 on proliferation, migration, invasion, and epithelial-mesenchymal transformation (EMT) of pancreatic cancer cells and explore its underlying mechanisms.

Methods: Pancreatic cancer cell models with either reduced HSP70 or increased HSP70 expression were established. RT-qPCR and Western blot assays were used to determine mRNA and protein levels of HSP70, IKK/IκBa/NF-κB signaling pathway-related genes, and EMT markers. The CCK-8 and cell cloning assays were used to evaluate cell proliferation and cloning abilities. Transwell and wound healing assays were used to assess the invasive and migratory properties of the cells. Effects of NF-κB signaling modulation were explored using an IKK inhibitor (BAY11-7082) and an IKK overexpression vector (pCMV-IKK). Electrophoretic mobility shift assay (EMSA) and luciferase reporter assays were conducted to analyze NF-κB's promoter binding and transcriptional activities.

Results: HSP70 knockdown inhibited p-p65 nuclear translocation and reduced the expression of p-p65, p-IKKα/β, p-IκBα, N-cadherin, Vimentin, and Twist. It also decreased NF-κB's promoter binding and transcriptional activities, increased E-cadherin levels, and suppressed pancreatic cancer cell proliferation, cloning, migration, and invasion. In contrast, HSP70 overexpression led to increased expression of p-p65, p-IKKα/β, p-IκBα, N-cadherin, Vimentin, and Twist, decreased E-cadherin levels, and enhanced cell proliferation, cloning, migration, and invasion capabilities. NF-κB signaling pathway modulation reversed EMT changes induced by altered HSP70 expression levels. rhHSP70 also increased p-IKKα/β and p-IκBα protein levels.

Conclusion: HSP70 promotes the EMT and enhances pancreatic cancer cell proliferation, migration, and invasion by activating the NF-κB pathway.

目的研究 HSP70 对胰腺癌细胞增殖、迁移、侵袭和上皮-间质转化(EMT)的影响,并探索其潜在机制:方法:建立 HSP70 表达减少或增加的胰腺癌细胞模型。采用 RT-qPCR 和 Western 印迹分析法测定 HSP70、IKK/IκBa/NF-κB 信号通路相关基因和 EMT 标志物的 mRNA 和蛋白水平。CCK-8 和细胞克隆试验用于评估细胞增殖和克隆能力。透孔试验和伤口愈合试验用于评估细胞的侵袭和迁移特性。使用 IKK 抑制剂(BAY11-7082)和 IKK 过表达载体(pCMV-IKK)探讨了 NF-κB 信号调节的效果。电泳迁移实验(EMSA)和荧光素酶报告实验分析了NF-κB的启动子结合和转录活性:结果:HSP70敲除抑制了p-p65的核转位,并降低了p-p65、p-IKKα/β、p-IκBα、N-cadherin、Vimentin和Twist的表达。它还能降低 NF-κB 的启动子结合和转录活性,提高 E-cadherin 水平,抑制胰腺癌细胞的增殖、克隆、迁移和侵袭。相反,过量表达 HSP70 会导致 p-p65、p-IKKα/β、p-IκBα、N-cadherin、Vimentin 和 Twist 表达增加,E-cadherin 水平降低,细胞增殖、克隆、迁移和侵袭能力增强。NF-κB信号通路调控逆转了HSP70表达水平改变所诱导的EMT变化,rhHSP70还增加了p-IKKα/β和p-IκBα蛋白水平:结论:HSP70 通过激活 NF-κB 通路促进 EMT 并增强胰腺癌细胞的增殖、迁移和侵袭。
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引用次数: 0
Combined EUS and ERCP in patients with malignant distal biliary obstruction is associated with reduced time to oncological therapy compared to ERCP and sampling alone. 在恶性远端胆道梗阻患者中联合使用 EUS 和 ERCP 与单独使用 ERCP 和取样相比,可缩短肿瘤治疗时间。
IF 1.7 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-08-08 DOI: 10.1097/MPA.0000000000002401
James Gauci, Wei On, Bharat Paranandi, Matthew Huggett, Simon Everett

Objectives: Standard ERCP sampling techniques for pancreaticobiliary malignancy have modest yields that could lead to delays in treatment. We aimed to evaluate whether combining EUS guided tissue acquisition (EUS-TA) with ERCP versus ERCP alone at the time of index procedure improved time to first outpatient evaluation and oncological treatment.

Methods: All patients without a prior pathological diagnosis who underwent index ERCP at Leeds Teaching Hospitals NHS Trust, United Kingdom, for malignant distal biliary obstruction from 2015 to 2020 were considered.

Results: A total of 292 patients were included, of whom 74.7% (n = 202) underwent EUS-TA/ERCP. A combined approach was more likely to establish a positive diagnosis (96.5% (n = 195) vs 57.8% (n = 52), p < 0.01) and less likely to require further sampling procedures (2.0% (n = 4) vs 17.8% (n = 16), p < 0.01). Mean times to first outpatient evaluation (16.9 vs 24.5 days (p = 0.01)) and oncological treatment (55.1 vs 79.3 days (p = 0.03)) were significantly shorter in the EUS-TA/ERCP group. A third (n = 86) of patients with a positive diagnosis did not receive oncological/surgical treatment.

Conclusions: In our cohort of patients, a combined approach was associated with improved diagnostic yield, reduced need for repeat sampling procedures and reduced time to evaluation and treatment, with similar therapeutic success and adverse event rates. Careful multidisciplinary discussion is recommended to avoid performing unnecessary EUS procedures on patients who will not benefit from further treatment.

目的:胰胆管恶性肿瘤的标准ERCP取样技术产量不高,可能导致治疗延误。我们的目的是评估ERCP与EUS引导下组织采集(EUS-TA)相结合与单纯ERCP相结合是否能缩短首次门诊评估和肿瘤治疗的时间:方法:研究对象为2015年至2020年期间在英国利兹教学医院NHS信托基金接受ERCP手术的所有恶性远端胆道梗阻患者,这些患者均未进行病理诊断:共纳入292名患者,其中74.7%(n = 202)接受了EUS-TA/ERCP检查。联合方法更有可能确定阳性诊断(96.5%(n = 195)vs 57.8%(n = 52),p < 0.01),而且需要进一步取样的可能性较小(2.0%(n = 4)vs 17.8%(n = 16),p < 0.01)。EUS-TA/ERCP组患者首次门诊评估(16.9天 vs 24.5天(P = 0.01))和肿瘤治疗(55.1天 vs 79.3天(P = 0.03))的平均时间明显更短。三分之一(n = 86)的阳性诊断患者没有接受肿瘤/手术治疗:结论:在我们的患者队列中,联合方法提高了诊断率,减少了重复取样程序的需要,缩短了评估和治疗时间,同时治疗成功率和不良事件发生率相似。建议进行仔细的多学科讨论,以避免对无法从进一步治疗中获益的患者进行不必要的 EUS 手术。
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引用次数: 0
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Pancreas
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