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Sosnowski K, Nehring P, Przybyłkowski A. Pancreas and Adverse Drug Reactions: A Literature Review. Drug Saf 2022; 45:929-939. [PMID: 35788538 DOI: 10.1007/s40264-022-01204-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/03/2022]
Abstract
Adverse drug reactions (ADRs) affecting the pancreas are a heterogeneous group of side effects that cause damage to pancreatic cells. Various mechanisms such as hypersensitization, sphincter of Oddi constriction, direct cytotoxic and metabolic effects on pancreatic cells, and dose-dependent idiosyncrasy lead to intrapancreatic activation of pancreatic enzymes resulting in drug-induced acute pancreatitis. Several medications have been linked with the development of pancreatic cancer. Pancreatic cancer may result from proinflammatory, proliferative, and antiapoptotic effects. Diabetogenic effect of drugs, which is understood as impairment of insulin secretion, may occur due to direct destruction of β cells, systemic toxicity affecting pancreatic islets and cell membrane glucose transporters, induction of Th1-type autoimmune response, and impairment of voltage-gated calcium channels in β cells, endoplasmic reticulum stress, and insulin signaling. A better understanding of ADRs that affect the pancreas may contribute to improving the awareness of clinicians and patients and reducing potential harmful side effects of implemented therapies.
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Affiliation(s)
- Konrad Sosnowski
- Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Piotr Nehring
- Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland
| | - Adam Przybyłkowski
- Department of Gastroenterology and Internal Medicine, Medical University of Warsaw, Banacha 1a, 02-097, Warsaw, Poland.
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Gajawada P, Cetinkaya A, von Gerlach S, Kubin N, Burger H, Näbauer M, Grinninger C, Rolf A, Schönburg M, Choi YH, Kubin T, Richter M. Myocardial Accumulations of Reg3A, Reg3γ and Oncostatin M Are Associated with the Formation of Granulomata in Patients with Cardiac Sarcoidosis. Int J Mol Sci 2021; 22:ijms22084148. [PMID: 33923774 PMCID: PMC8072627 DOI: 10.3390/ijms22084148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/24/2021] [Accepted: 04/10/2021] [Indexed: 12/13/2022] Open
Abstract
Cardiac sarcoidosis (CS) is a poorly understood disease and is characterized by the focal accumulation of immune cells, thus leading to the formation of granulomata (GL). To identify the developmental principles of fatal GL, fluorescence microscopy and Western blot analysis of CS and control patients is presented here. CS is visualized macroscopically by positron emission tomography (PET)/ computed tomography (CT). A battery of antibodies is used to determine structural, cell cycle and inflammatory markers. GL consist of CD68+, CD163+ and CD206+ macrophages surrounded by T-cells within fibrotic areas. Cell cycle markers such as phospho-histone H3, phospho-Aurora and Ki67 were moderately present; however, the phosphorylated ERM (ezrin, radixin and moesin) and Erk1/2 proteins, strong expression of the myosin motor protein and the macrophage transcription factor PU.1 indicate highly active GL. Mild apoptosis is consistent with PI3 kinase and Akt activation. Massive amounts of the IL-1R antagonist reflect a mild activation of stress and inflammatory pathways in GL. High levels of oncostatin M and the Reg3A and Reg3γ chemokines are in accordance with macrophage accumulation in areas of remodeling cardiomyocytes. We conclude that the formation of GL occurs mainly through chemoattraction and less by proliferation of macrophages. Furthermore, activation of the oncostatin/Reg3 axis might help at first to wall-off substances but might initiate the chronic development of heart failure.
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Affiliation(s)
- Praveen Gajawada
- Department of Cardiac Surgery, Kerckhoff Heart Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany; (P.G.); (A.C.); (N.K.); (H.B.); (M.S.)
| | - Ayse Cetinkaya
- Department of Cardiac Surgery, Kerckhoff Heart Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany; (P.G.); (A.C.); (N.K.); (H.B.); (M.S.)
- Campus Kerckhoff, Justus-Liebig-University Giessen, 61231 Bad Nauheim, Germany;
| | - Susanne von Gerlach
- Universitätsklinikum Giessen und Marburg GmbH, Standort Marburg, Baldingerstr., 35033 Marburg, Germany;
| | - Natalia Kubin
- Department of Cardiac Surgery, Kerckhoff Heart Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany; (P.G.); (A.C.); (N.K.); (H.B.); (M.S.)
| | - Heiko Burger
- Department of Cardiac Surgery, Kerckhoff Heart Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany; (P.G.); (A.C.); (N.K.); (H.B.); (M.S.)
- Campus Kerckhoff, Justus-Liebig-University Giessen, 61231 Bad Nauheim, Germany;
| | - Michael Näbauer
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Marchioninistr. 15, 81377 Munich, Germany; (M.N.); (C.G.)
| | - Carola Grinninger
- Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Marchioninistr. 15, 81377 Munich, Germany; (M.N.); (C.G.)
| | - Andreas Rolf
- Campus Kerckhoff, Justus-Liebig-University Giessen, 61231 Bad Nauheim, Germany;
- Department of Cardiology, Kerckhoff Heart and Lung Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany
| | - Markus Schönburg
- Department of Cardiac Surgery, Kerckhoff Heart Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany; (P.G.); (A.C.); (N.K.); (H.B.); (M.S.)
- Campus Kerckhoff, Justus-Liebig-University Giessen, 61231 Bad Nauheim, Germany;
| | - Yeong-Hoon Choi
- Department of Cardiac Surgery, Kerckhoff Heart Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany; (P.G.); (A.C.); (N.K.); (H.B.); (M.S.)
- Campus Kerckhoff, Justus-Liebig-University Giessen, 61231 Bad Nauheim, Germany;
- German Center for Cardiovascular Research (DZHK), Partner Site RhineMain, 60549 Frankfurt/Main, Germany
- Correspondence: (Y.-H.C.); (T.K.); (M.R.)
| | - Thomas Kubin
- Department of Cardiac Surgery, Kerckhoff Heart Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany; (P.G.); (A.C.); (N.K.); (H.B.); (M.S.)
- Correspondence: (Y.-H.C.); (T.K.); (M.R.)
| | - Manfred Richter
- Department of Cardiac Surgery, Kerckhoff Heart Center, Benekestr. 2-8, 61231 Bad Nauheim, Germany; (P.G.); (A.C.); (N.K.); (H.B.); (M.S.)
- Campus Kerckhoff, Justus-Liebig-University Giessen, 61231 Bad Nauheim, Germany;
- Correspondence: (Y.-H.C.); (T.K.); (M.R.)
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