Protein profiles of CCL5, HPGDS, and NPSR1 in plasma reveal association with childhood asthma

Asthma is a common chronic childhood disease with many different phenotypes that need to be identified. We analyzed a broad range of plasma proteins in children with well-characterized asthma phenotypes to identify potential markers of childhood asthma. Using an affinity proteomics approach, plasma levels of 362 proteins covered by antibodies from the Human Protein Atlas were investigated in a total of 154 children with persistent or intermittent asthma and controls. After screening, chemokine ligand 5 (CCL5) hematopoietic prostaglandin D synthase (HPGDS) and neuropeptide S receptor 1 (NPSR1) were selected for further investigation. Significantly lower levels of both CCL5 and HPGDS were found in children with persistent asthma, while NPSR1 was found at higher levels in children with mild intermittent asthma compared to healthy controls. In addition, the protein levels were investigated in another respiratory disease, sarcoidosis, showing significantly higher NPSR1 levels in sera from sarcoidosis patients compared to healthy controls. Immunohistochemical staining of healthy tissues revealed high cytoplasmic expression of HPGDS in mast cells, present in stroma of both airway epithelia, lung as well as in other organs. High expression of NPSR1 was observed in neuroendocrine tissues, while no expression was observed in airway epithelia or lung. In conclusion, we have utilized a broad-scaled affinity proteomics approach to identify three proteins with altered plasma levels in asthmatic children, representing one of the first evaluations of HPGDS and NPSR1 protein levels in plasma.

Can somatostatin prevent injection pancreatitis after ERCP?

In a double-blind randomized study, 30 patients received somatostatin infusion during ERCP and 30 patients placebo with the aim of evaluating whether somatostatin can reduce the incidence of injection pancreatitis. S-amylase, U-amylase and S-lipase were evaluated before, during and after (up to 48 hours) ERCP. C-peptide was also determined as a marker of the function of the endocrine pancreas. While no statistically significant effect of somatostatin in terms of amylase and lipase was to be found, somatostatin did significantly decrease c-peptide levels in plasma, indicating that the peptide inhibited beta-cell secretion. About 40% of patients in the somatostatin group and about 50% in the placebo group showed signs of injection pancreatitis (elevated levels of enzymes) and in both groups there are patients with clinically apparent pancreatitis.

Selective deficiency of pancreatic amylase

Two patients with specific pancreatic amylase deficiency are described. The greatly reduced pancreatic amylase activity was not due to an enzymatically inactive amylase molecule but to an almost complete absence of the molecule itself. The findings are of diagnostic importance as they show that low pancreatic amylase activity in serum or duodenal aspirates, or both, does not necessarily represent chronic exocrine pancreatic disease such as chronic pancreatitis, carcinoma of the pancreas, or cystic fibrosis but may be an isolated finding. In one of our patients a familial occurrence was shown, indicating a congenital deficiency.

The estrogen binding protein in human pancreas: concentrations in subcellular fractions of normal pancreatic tissue, in duodenal juice during pancreatic stimulation and in peripheral serum in normal and pathological conditions

The steroid binding properties of the human pancreatic estrogen binding protein (hEBP) in cytosol were studied by equilibrium dialysis. A high ligand specificity of the protein was revealed. hEBP in cytosol binds unconjugated steroid estrogens with a medium affinity (Kd = 10(-7) M) but does not bind conjugated estrogens or unconjugated androgens, gestagens, glucocorticoids or cholesterol. Quantitation of hEBP by radioimmunoassay in subcellular fractions of human pancreatic tissue indicated that the protein is translocated into different subcellular compartments. Duodenal juice taken from patients following stimulation of pancreatic secretion by food ingestion (Lund's test) showed high hEBP concentrations, and the levels of hEBP changed concomitantly with the levels of pancreatic isoamylase, indicating that hEBP secretion was stimulated by food ingestion. The levels of hEBP in peripheral serum from healthy subjects showed no sex difference, but were positively correlated to age. Highly elevated (10-20-fold) hEBP levels were found in serum from patients with acute pancreatitis, while normal serum hEBP values were found in other abdominal diseases. It is speculated that hEBP might have a specific role in the transport of estrogens from the peripheral circulation via the pancreas to the duodenum. The elevated hEBP levels in patients with acute pancreatitis indicate that this protein may be used as a marker of cellular damage in the pancreas.

Segmental pancreatic transplantation in Stockholm

Fifty-nine pancreatic transplantations have been performed at Huddinge Hospital between May 1974 and October 1985 with a substantial improvement in results over the years. In the most recent series, consisting of 19 combined renal and pancreatic transplantations performed May 1984 to September 1985; the 1-year actuarial patient survival and pancreatic graft survival were 86% and 66% respectively. Thirteen of these grafts are functional presently, at 18 to 2 months, and all such patients are insulin free and exhibit normal metabolic control. Our practice includes drainage of the pancreatic juice to the exterior by means of a pancreatic duct catheter during the first 2-3 postoperative weeks, thereby promoting healing of the pancreatico-enteric anastomosis. Although cold ischemia time was kept low in this series, a moderate graft pancreatitis developed, with a peak serum amylase level of 16.8 + 2.2 ukat/l and a peak amylase activity in the peripancreatic fluid of 280 + 110 ukat/l. The volume of pancreatic juice from the ductal catheter was very low in the first postoperative days but then rose to reach a plateau level of about 500 ml/day. The amylase activity in this juice was very high (9100 + 2500 ukat/l) during the first postoperative day, but then gradually decreased to reach a steady level around 3000 ukat/l after 4-7 days.