[Show abstract][Hide abstract] ABSTRACT: [目的]Interleukin-10 (IL-10)は抗炎症性サイトカインとして知られており,セルレイン(Cn)やコリンデフィシエントを用いた実験膵炎モデルでIL-10を投与することで膵炎が改善するという報告がある.今回我々は,セルレインおよび,リポポリサッカライド(LPS)を用いたマウス壊死性膵炎モデルを作製し,IL-10の投与効果を検討した.[方法]マウスにLPS 10mg/kg1回(Cn初回投与時)腹腔内投与+Cn 50μg/kg 1時間毎に計10回腹腔内投与して膵炎を作製し,IL-10 10,000 UをCnおよびLPS初回投与1時間前より2時間毎に計7回投与し,その投与効果を検討した.[結果](1)血清膵酵素上昇はCn初回投与時より12,24時間後でIL-10投与により抑制された.(2)膵組織学的にCn初回投与時より12,24時間後でIL-10投与により空胞形成や壊死が軽減した.(3)分子生物学的にCn初回投与時より3,6,12,24時間後でIL-10投与により膵組織中のTNFα,IL-1βmRNAの発現が抑制された.[結論]IL-10は実験壊死性膵炎において,TNFα,IL-1βの産生を抑制し,重症化を軽減させると考えられた. Interleukin-10 (IL-10) has recently been identified as a major anti-inflammatory cytokine, and there have been several reports that IL-10 administration reduces severe necrosis in cerulein- or choline deficient (CDE) -induced pancreatitis. We investigated the effect of IL-10 in a mouse model of acute necrotizing pancreatitis induced by ten intraperitoneal infusion of cerulein (50 μg/kg) at hourly intervals and a single intraperitoneal injection of LPS (10 mg/kg) concomitant with the first cerulein injection. The IL-10 treated group was also injected with 10,000 U of IL-10 seven times intraperitoneally every 2 h beginning 1 h before the cerulein infusion. The pancreas was examined for histological changes and analyzed for tissue TNFα mRNA and IL-1β mRNA by RT-PCR. Serum amylase and lipase release peaked at 12 h after the first cerulein injection, but their concentrations at 12 and 24 h were significantly reduced by IL-10. Histologically, acinar cell necrosis and vacuolization were dramatically attenuated at 12 and 24 h in the IL-10 treated group, and induction of tissue TNFα mRNA and IL-1β mRNA in the pancreas was significantly reduced by IL-10. In conclusion, IL-10 is capable of decreasing the severity of experimental acute necrotizing pancreatitis. Inhibition of TNFα and IL-1β production in the pancreas may explain the protective effect of IL-10.
[Show abstract][Hide abstract] ABSTRACT: A 65-year-old female complaining of epigastric pain was admitted to our hospital. Laboratory data showed the elevation of biliary and pancreatic enzymes. The swelling and redness of papilla of Vater was observed by duodenoscope. The biopsy examination revealed adenocarcinoma. ERCP showed pancreas divisum, and the ventral pancreatic duct was dialated. EUS and IDUS showed a hypoechoic mass of about 20 mm diameter at the papilla of Vater, and the invasion into the pancreatic duct could not be excluded. Surgical material revealed papillary adenocarcinoma of 25mm in size showing no invasion into duodenum and pancreas. The surgical stage was stage I. We reviwed 6 cases of pancreas divisum concomitant with carcinoma of papilla of Vater in Japanese literature.
[Show abstract][Hide abstract] ABSTRACT: To clarify the role of nitric oxide (NO) in the development and progression of acute pancreatitis, we investigated the effect of different NO synthase inhibitors and NO donors on experimental pancreatitis in rats. Closed duodenal loop (CDL)-induced pancreatitis was produced in male Wistar rats, and the animals were treated with normal saline, the NO-synthase substrate L-arginine, the NO donor S-nitroso-N-acetylpenicillamine, aminoguanidine, which is a more powerful inhibitor of inducible NO synthase (iNOS) than is endothelial NO synthase (eNOS), and N-nitro-L-arginine methyl ester (L-NAME), a more powerful inhibitor of eNOS than of iNOS. All drugs were infused intravenously during a period of 6 or 12 h in each group. Pancreatic tissue was removed at 6 and 12 h after creating the CDL. L-Arginine, S-nitroso-N-acetyl-penicillamine, and aminoguanidine treatment had no effect on the elevation of serum pancreatic enzymes, whereas L-NAME administration significantly exacerbated their elevation. Pathologically, L-NAME treatment resulted in a significantly worse histologic score at 6 and 12 h, especially in terms of the degree of hemorrhage, acinar cell necrosis, and microvascular thrombosis. Addition of L-arginine clearly reversed the effect of L-NAME. Neither the NO substrate nor NO donor could inhibit the progression of hemorrhagic pancreatitis in CDL-induced pancreatitis. Aminoguanidine had no effect on the severity of the pancreatitis. We therefore concluded that NO production by eNOS may play a significant role in preventing the development and progression of acute pancreatitis.
[Show abstract][Hide abstract] ABSTRACT: Several authors have reported a case of chronic pancreatitis associated with Sjgren's syndrome in which an autoimmune mechanism may have been involved in the etrology and in which steroid therapy was effective. We recently encountered a patient with pancreatitis who had hyperglobulinemia, was autoantibody-positive, and responded to steroid therapy. This patient, however, failed to show any evidence of association with Sjgren's syndrome or other collagen diseases. Although the concept of autoimmune hepatitis and the criteria for diagnosing it have been established, autoimmune pancreatitis has not yet been defined as a clinical entity. We report a case of chronic pancreatitis in which an autoimmune mechanism is involved in the etiology and summarize the cases of pancreatitis suspected of being caused by an autoimmune mechanism in the Japanese and English literature.
No preview · Article · Jun 1995 · Digestive Diseases and Sciences
[Show abstract][Hide abstract] ABSTRACT: Responses of serum gastrin to both intravenous infusion of secretin (GIH secretin 3 CU/kg/hr) and intravenous bolus injection
(GIH secretin 1 CU/kg) were studied in 2 Zollinger-Ellison syndrome (ZE) patients and 27 duodenal ulcer (DU) patients. In
all of the DU patients, the stage of the ulcer was determined endoscopically, prior to testing, as either active or healed.
We found that the responses of serum gastrin to secretin were closely related to the stage of the duodenal ulcer; serum gastrin
increased in the active stage and decreased in the healed stage. In patients with active duodenal ulcer, a false positive
(ZE-like) response to exogenous secretin was observed. Comparing the results of intravenous infusion and bolus administration
of secretin in terms of maximal percent change of serum gastrin, there was no significant difference between the two methods,
confirming the works reported by others.
No preview · Article · Jan 1982 · Journal of Gastroenterology