1
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Lin F, Lu R, Han D, Fan Y, Zhang Y, Pan P. A prediction model for acute respiratory distress syndrome among patients with severe acute pancreatitis: a retrospective analysis. Ther Adv Respir Dis 2022; 16:17534666221122592. [PMID: 36065909 PMCID: PMC9459476 DOI: 10.1177/17534666221122592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Acute respiratory distress syndrome (ARDS) is a severe complication among
patients with severe acute pancreatitis (SAP), which may be associated with
increased mortality in hospitalized patients. Thus, an effective model to
predict ARDS in patients with SAP is urgently required. Methods: We retrospectively analyzed the data from the patients with SAP who recruited
in Xiangya Hospital between April 2017 and May 2021. Patients meeting the
Berlin definition of ARDS were categorized into the ARDS group. Logistic
regression models and a nomogram were utilized in the study. Descriptive
statistics, logistic regression models, and a nomogram were used in the
current study. Results: Comorbidity of ARDS occurred in 109 (46.58%) of 234 patients with SAP. The
SAP patients with ARDS group had a higher 60-day mortality rate, an
increased demand for invasive mechanical ventilation, and a longer intensive
care unit (ICU) stay than those without ARDS (p < .001
for all). Partial pressure of oxygen (PaO2): fraction of inspired oxygen
(FiO2) < 200, platelets <125 × 109/L, lactate
dehydrogenase >250 U/L, creatinine >111 mg/dL, and
procalcitonin >0.5 ng/mL were independent risk variables for development
of ARDS in SAP patients. The area under the curve for the model was 0.814,
and the model fit was acceptable [p = .355
(Hosmer–Lemeshow)]. Incorporating these 5 factors, a nomogram was
established with sufficient discriminatory power (C-index 0.814).
Calibration curve indicated the proper discrimination and good calibration
in the predicting nomogram model. Conclusion: The prediction nomogram for ARDS in patients with SAP can be applied using
clinical common variables after the diagnosis of SAP. Future studies would
be warranted to verify the potential clinical benefits of this model.
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Affiliation(s)
- Fengyu Lin
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China.,National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Rongli Lu
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China.,National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Duoduo Han
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.,Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China.,National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Yifei Fan
- Department of Critical Care Medicine, Xijing Hospital, Air Force Military Medical University, 15th Changle West Rd, Xi'an 710032, Shaanxi, China
| | - Yan Zhang
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.,Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China.,National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Pinhua Pan
- Center of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China.,Hunan Engineering Research Center for Intelligent Diagnosis and Treatment of Respiratory Disease, Changsha, China.,National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
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2
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Postić S, Gosak M, Tsai WH, Pfabe J, Sarikas S, Stožer A, Korošak D, Yang SB, Slak Rupnik M. pH-Dependence of Glucose-Dependent Activity of Beta Cell Networks in Acute Mouse Pancreatic Tissue Slice. Front Endocrinol (Lausanne) 2022; 13:916688. [PMID: 35837307 PMCID: PMC9273738 DOI: 10.3389/fendo.2022.916688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 05/24/2022] [Indexed: 12/01/2022] Open
Abstract
Extracellular pH has the potential to affect various aspects of the pancreatic beta cell function. To explain this effect, a number of mechanisms was proposed involving both extracellular and intracellular targets and pathways. Here, we focus on reassessing the influence of extracellular pH on glucose-dependent beta cell activation and collective activity in physiological conditions. To this end we employed mouse pancreatic tissue slices to perform high-temporally resolved functional imaging of cytosolic Ca2+ oscillations. We investigated the effect of either physiological H+ excess or depletion on the activation properties as well as on the collective activity of beta cell in an islet. Our results indicate that lowered pH invokes activation of a subset of beta cells in substimulatory glucose concentrations, enhances the average activity of beta cells, and alters the beta cell network properties in an islet. The enhanced average activity of beta cells was determined indirectly utilizing cytosolic Ca2+ imaging, while direct measuring of insulin secretion confirmed that this enhanced activity is accompanied by a higher insulin release. Furthermore, reduced functional connectivity and higher functional segregation at lower pH, both signs of a reduced intercellular communication, do not necessary result in an impaired insulin release.
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Affiliation(s)
- Sandra Postić
- Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
- *Correspondence: Sandra Postić,
| | - Marko Gosak
- Institute of Physiology, Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Faculty of Natural Sciences and Mathematics, University of Maribor, Maribor, Slovenia
| | - Wen-Hao Tsai
- Taiwan International Graduate Program in Molecular Medicine, National Yang Ming Chiao Tung University and Academia Sinica, Taipei, Taiwan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Johannes Pfabe
- Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Srdjan Sarikas
- Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Andraž Stožer
- Institute of Physiology, Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Dean Korošak
- Institute of Physiology, Faculty of Medicine, University of Maribor, Maribor, Slovenia
| | - Shi-Bing Yang
- Taiwan International Graduate Program in Molecular Medicine, National Yang Ming Chiao Tung University and Academia Sinica, Taipei, Taiwan
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Marjan Slak Rupnik
- Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
- Institute of Physiology, Faculty of Medicine, University of Maribor, Maribor, Slovenia
- Alma Mater Europaea – European Center Maribor, Maribor, Slovenia
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3
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Abstract
Acute and chronic pancreatitises are gastrointestinal inflammatory diseases, the incidence of which is increasing worldwide. Most (~ 80%) acute pancreatitis (AP) patients have mild disease, and about 20% have severe disease, which causes multiple organ failure and has a high mortality rate. Chronic pancreatitis (CP) is characterized by chronic inflammation and destruction of normal pancreatic parenchyma, which leads to loss of exocrine and endocrine tissues. Patients with CP also have a higher incidence of pancreatic ductal adenocarcinoma. Although a number of factors are associated with the development and progression of AP and CP, the underlying mechanism is unclear. Adhesion molecules play important roles in cell migration, proliferation, and signal transduction, as well as in development and tissue repair. Loosening of cell-cell adhesion between pancreatic acinar cells and/or endothelial cells increases solute permeability, resulting in interstitial edema, which promotes inflammatory cell migration and disrupts tissue structure. Oxidative stress, which is one of the important pathogenesis of pancreatitis, leads to upregulation of adhesion molecules. Soluble adhesion molecules are reportedly involved in AP. In this review, we focus on the roles of tight junctions (occludin, tricellulin, claudin, junctional adhesion molecule, and zonula occludin), adherens junctions (E-cadherin and p120-, α-, and β-catenin), and other adhesion molecules (selectin and intercellular adhesion molecules) in the progression of AP and CP. Maintaining the normal function of adhesion molecules and preventing their abnormal activation maintain the structure of the pancreas and prevent the development of pancreatitis.
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Affiliation(s)
- Takeshi Sato
- 0000 0001 1033 6139grid.268441.dDepartment of Gastroenterology, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Wataru Shibata
- 0000 0001 1033 6139grid.268441.dDepartment of Gastroenterology, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan ,0000 0001 1033 6139grid.268441.dDivision of Translational Research, Advanced Medical Research Center, Yokohama City University, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Shin Maeda
- 0000 0001 1033 6139grid.268441.dDepartment of Gastroenterology, Yokohama City University Graduate School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
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4
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Merry TL, Petrov MS. The rise of genetically engineered mouse models of pancreatitis: A review of literature. Biomol Concepts 2018; 9:103-114. [DOI: 10.1515/bmc-2018-0011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/19/2018] [Indexed: 12/15/2022] Open
Abstract
AbstractPancreatitis is increasingly recognized as not merely a local inflammation of the pancreas but also a disease with high frequency of systemic sequelae. Current understanding of the cellular mechanisms that trigger it and affect the development of sequelae are limited. Genetically engineered mouse models can be a useful tool to study the pathophysiology of pancreatitis. This article gives an overview of the genetically engineered mouse models that spontaneously develop pancreatitis and discusses those that most closely replicate different pancreatitis hallmarks observed in humans.
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Affiliation(s)
- Troy L. Merry
- Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, New Zealand
- Discipline of Nutrition, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Maxim S. Petrov
- Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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5
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Rumbus Z, Toth E, Poto L, Vincze A, Veres G, Czako L, Olah E, Marta K, Miko A, Rakonczay Z, Balla Z, Kaszaki J, Foldesi I, Maleth J, Hegyi P, Garami A. Bidirectional Relationship Between Reduced Blood pH and Acute Pancreatitis: A Translational Study of Their Noxious Combination. Front Physiol 2018; 9:1360. [PMID: 30327613 PMCID: PMC6174522 DOI: 10.3389/fphys.2018.01360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 09/07/2018] [Indexed: 12/13/2022] Open
Abstract
Acute pancreatitis (AP) is often accompanied by alterations in the acid-base balance, but how blood pH influences the outcome of AP is largely unknown. We studied the association between blood pH and the outcome of AP with meta-analysis of clinical trials, and aimed to discover the causative relationship between blood pH and AP in animal models. PubMed, EMBASE, and Cochrane Controlled Trials Registry databases were searched from inception to January 2017. Human studies reporting systemic pH status and outcomes (mortality rate, severity scores, and length of hospital stay) of patient groups with AP were included in the analyses. We developed a new mouse model of chronic metabolic acidosis (MA) and induced mild or severe AP in the mice. Besides laboratory blood testing, the extent of pancreatic edema, necrosis, and leukocyte infiltration were assessed in tissue sections of the mice. Thirteen studies reported sufficient data in patient groups with AP (n = 2,311). Meta-analysis revealed markedly higher mortality, elevated severity scores, and longer hospital stay in AP patients with lower blood pH or base excess (P < 0.001 for all studied outcomes). Meta-regression analysis showed significant negative correlation between blood pH and mortality in severe AP. In our mouse model, pre-existing MA deteriorated the pancreatic damage in mild and severe AP and, vice versa, severe AP further decreased the blood pH of mice with MA. In conclusion, MA worsens the outcome of AP, while severe AP augments the decrease of blood pH. The discovery of this vicious metabolic cycle opens up new therapeutic possibilities in AP.
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Affiliation(s)
- Zoltan Rumbus
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Emese Toth
- Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences-University of Szeged, Szeged, Hungary.,First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Laszlo Poto
- Institute of Bioanalysis, Medical School, University of Pecs, Pecs, Hungary
| | - Aron Vincze
- Department of Gastroenterology, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Gabor Veres
- First Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Laszlo Czako
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Emoke Olah
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Katalin Marta
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Alexandra Miko
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Zoltan Rakonczay
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Zsolt Balla
- Department of Pathophysiology, University of Szeged, Szeged, Hungary
| | - Jozsef Kaszaki
- Institute of Surgical Research, University of Szeged, Szeged, Hungary
| | - Imre Foldesi
- Department of Laboratory Medicine, University of Szeged, Szeged, Hungary
| | - Jozsef Maleth
- First Department of Medicine, University of Szeged, Szeged, Hungary.,Momentum Epithel Cell Signaling and Secretion Research Group, Hungarian Academy of Sciences-University of Szeged, Szeged, Hungary
| | - Peter Hegyi
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary.,Momentum Gastroenterology Multidisciplinary Research Group, Hungarian Academy of Sciences-University of Szeged, Szeged, Hungary.,Department of Translational Medicine, First Department of Medicine, University of Pecs, Pecs, Hungary
| | - Andras Garami
- Institute for Translational Medicine, Medical School, University of Pecs, Pecs, Hungary
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6
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Iyyathurai J, Decuypere JP, Leybaert L, D'hondt C, Bultynck G. Connexins: substrates and regulators of autophagy. BMC Cell Biol 2016; 17 Suppl 1:20. [PMID: 27229147 PMCID: PMC4896244 DOI: 10.1186/s12860-016-0093-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Connexins mediate intercellular communication by assembling into hexameric channel complexes that act as hemichannels and gap junction channels. Most connexins are characterized by a very rapid turn-over in a variety of cell systems. The regulation of connexin turn-over by phosphorylation and ubiquitination events has been well documented. Moreover, different pathways have been implicated in connexin degradation, including proteasomal and lysosomal-based pathways. Only recently, autophagy emerged as an important connexin-degradation pathway for different connexin isoforms. As such, conditions well known to induce autophagy have an immediate impact on the connexin-expression levels. This is not only limited to experimental conditions but also several pathophysiological conditions associated with autophagy (dys)function affect connexin levels and their presence at the cell surface as gap junctions. Finally, connexins are not only substrates of autophagy but also emerge as regulators of the autophagy process. In particular, several connexin isoforms appear to recruit pre-autophagosomal autophagy-related proteins, including Atg16 and PI3K-complex components, to the plasma membrane, thereby limiting their availability and capacity for regulating autophagy.
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Affiliation(s)
- Jegan Iyyathurai
- KU Leuven, Laboratory of Molecular and Cellular Signaling, Department Cellular and Molecular Medicine, Campus Gasthuisberg O/N-I bus 802, Herestraat 49, B-3000, Leuven, Belgium
| | - Jean-Paul Decuypere
- KU Leuven, Laboratory for Membrane Trafficking, Department of Human Genetics, and VIB-Center for the Biology of Disease, Campus Gasthuisberg, O/N-IV, 7.159, Herestraat 49, 3000, Leuven, Belgium
| | - Luc Leybaert
- Ghent University, Physiology Group, Department of Basic Medical Sciences, 9000, Ghent, Belgium
| | - Catheleyne D'hondt
- KU Leuven, Laboratory of Molecular and Cellular Signaling, Department Cellular and Molecular Medicine, Campus Gasthuisberg O/N-I bus 802, Herestraat 49, B-3000, Leuven, Belgium
| | - Geert Bultynck
- KU Leuven, Laboratory of Molecular and Cellular Signaling, Department Cellular and Molecular Medicine, Campus Gasthuisberg O/N-I bus 802, Herestraat 49, B-3000, Leuven, Belgium.
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7
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Nutrient Starvation Decreases Cx43 Levels and Limits Intercellular Communication in Primary Bovine Corneal Endothelial Cells. J Membr Biol 2016; 249:363-73. [PMID: 26873723 DOI: 10.1007/s00232-016-9874-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 01/22/2016] [Indexed: 12/11/2022]
Abstract
Connexin (Cx) proteins form large conductance channels which function as regulators of communication between neighboring cells via gap junctions and/or hemichannels. Intercellular communication is essential to coordinate cellular responses in tissues and organs, thereby fulfilling an essential role in the spreading of signaling, survival and death processes. Connexin 43 (Cx43), a major connexin isoform in brain and heart, is rapidly turned over. Recent studies implicated that autophagy, a lysosomal degradation pathway induced upon nutrient starvation, mediates connexins, including Cx43, degradation. Here, we examined the impact of nutrient starvation on endogenous Cx43-protein levels and endogenous Cx43-driven intercellular communication in primary bovine corneal endothelial cells (BCECs). Hank's Balanced Salt Solution (HBSS) was used as a starvation condition that induces autophagic flux without impacting the survival of the BCECs. Nutrient starvation of BCECs caused a rapid decline in Cx43-protein levels, both as gap junctions and as hemichannels. The time course of the decline in Cx43-protein levels coincided with the time course of the decline in intercellular communication, assessed as intercellular Ca(2+)-wave propagation in BCECs exposed to a single-cell mechanical stimulus. The decline in Cx43-protein levels, both as gap junctions and as hemichannels, could be prevented by the addition of bafilomycin A1, a lysosomal inhibitor, during the complete nutrient starvation period. Consistent with this, bafilomycin A1 significantly alleviated the decrease in intercellular Ca(2+)-wave propagation. This study further underpins the importance of autophagy as an important degradation pathway for Cx43 proteins during periods of nutrient deprivation, thereby impacting the ability of cells to perform intercellular communication.
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8
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Abstract
The pancreas produces enzymes with a digestive function and hormones with a metabolic function, which are produced by distinct cell types of acini and islets, respectively. Within these units, secretory cells coordinate their functioning by exchanging information via signals that flow in the intercellular spaces and are generated either at distance (several neural and hormonal inputs) or nearby the pancreatic cells themselves (inputs mediated by membrane ionic-specific channels and by ionic- and metabolite-permeant pannexin channels and connexin "hemichannels"). Pancreatic secretory cells further interact via the extracellular matrix of the pancreas (inputs mediated by integrins) and directly with neighboring cells, by mechanisms that do not require extracellular mediators (inputs mediated by gap and tight junction channels). Here, we review the expression and function of the connexins and pannexins that are expressed by the main secretory cells of the exocrine and endocrine pancreatic cells. Available data show that the patterns of expression of these proteins differ in acini and islets, supporting distinct functions in the physiological secretion of pancreatic enzymes and hormones. Circumstantial evidence further suggests that alterations in the signaling provided by these proteins are involved in pancreatic diseases.
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9
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Abstract
PURPOSE OF REVIEW Acute pancreatitis is associated with alcohol abuse, gallstones and bacterial infection. Its basic cause is tissue destruction accompanied by an innate immune response, which induces epithelial stress pathways. Recent studies have focused on some of the integral cellular pathways shared between multiple pancreatitis models that also suggest new approaches to detection and treatment. RECENT FINDINGS Several models of pancreatitis have been associated with stress responses, such as endoplasmic reticulum and oxidative stress together with the induction of a defective autophagic pathway. Recent evidence reinforces the critical role of these cellular processes in pancreatitis. A member of the toll-like receptor family, toll-like receptor 4, which is known to contribute to disease pathology in many models of experimental pancreatitis, has been found to be a promising target for treatment of pancreatitis. Interestingly, a direct activator of toll-like receptor 4, the bacterial cell wall component in gram-negative bacteria lipopolysaccharide, contributes to the onset and severity of disease when combined with additional stressors, such as chronic alcohol feeding; however, recent studies have shown that acute infection of mice with live bacteria is alone sufficient to induce acute pancreatitis. SUMMARY In the last several months, the convergent roles of acinar cell stress, autophagy and proinflammatory signaling initiated by the toll-like receptors have been emphatically reinforced in the onset of acute pancreatitis.
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