Alterations in Enteroendocrine Hormones After Total Pancreatectomy With Islet Autotransplantation.


  • 影响因子:2.16
  • DOI:10.1097/MPA.0000000000001582
  • 作者列表:"McEachron KR","Yang Y","Hodges JS","Beilman GJ","Pruett TL","Kirchner VA","Dunn TB","Freeman ML","Trikudanathan G","Mulier KE","Ptacek P","Bellin MD
  • 发表时间:2020-06-12

OBJECTIVE:When total pancreatectomy with islet autotransplantation (TPIAT) is performed for chronic pancreatitis, the pancreas and most of the duodenum are removed, with Roux-en-Y reconstruction of the gastrointestinal tract. Enteroendocrine cells in the intestines and pancreas secrete hormones coordinating digestion and motility, but anatomic reconstruction alters transit of nutrients to these cells. We hypothesized that TPIAT leads to changes in enteroendocrine hormones. METHODS:Glucagon-like peptide 1 (GLP-1), peptide YY (PYY), and pancreatic polypeptide (PP) were measured from mixed-meal tolerance tests of 34 clinical trial participants before and 18 months after TPIAT. Area under the curve of GLP-1 and PYY-stimulated responses were calculated by trapezoidal method, and the PP response was measured as the stimulated max minus baseline (ΔPP). RESULTS:Area under the curve of GLP-1 and PYY increased significantly after TPIAT (GLP-1 average +553.1 pg/mL per minute, P = 0.004; PYY average +4647.9 pg/mL per minute, P = 0.02). ΔPP trended toward lower after TPIAT (average, -52.2 pg/mL, P = 0.06). CONCLUSIONS:In this novel study of enteroendocrine hormones in TPIAT patients, stimulated levels of GLP-1 and PYY were significantly higher after versus before TPIAT. ΔPP was lower after TPIAT, but not significantly. These hormone changes have potential clinical implications that warrant further research.


目的: 慢性胰腺炎行全胰腺切除加自体胰岛移植 (TPIAT) 时,切除胰腺和大部分十二指肠,行胃肠道 Roux-en-Y 重建。肠和胰腺中的肠内分泌细胞分泌协调消化和运动的激素,但解剖重建改变了营养物质向这些细胞的转运。我们假设 TPIAT 导致肠内分泌激素的变化。 方法: 胰高血糖素样肽 1 (GLP-1) 、肽 YY (PYY) 和胰多肽 (PP) 在 TPIAT 前和 18 个月后对 34 名临床试验参与者进行混合餐耐受性试验。通过梯形法计算 GLP-1 和 PYY 刺激反应的曲线下面积,并测量 PP 反应作为刺激的最大值减去基线 (Δ PP)。 结果: TPIAT 后 GLP-1 和 PYY 的曲线下面积显著增加 (GLP-1 平均每分钟 + 553.1 pg/mL,P = 0.004; PYY 平均每分钟 + 4647.9 pg/mL,P = 0.02)。TPIAT 后 Δ pp 趋向于更低 (平均值,-52.2 pg/mL,P = 0.06)。 结论: 在这项关于 TPIAT 患者肠内分泌激素的新研究中,与 TPIAT 前相比,TPIAT 后刺激的 GLP-1 和 PYY 水平显著升高。TPIAT 后 Δ pp 较低,但不显著。这些激素变化具有潜在的临床意义,值得进一步研究。



作者列表:["Akula SM","Ruvolo PP","McCubrey JA"]

METHODS::Pancreatic ductal adenocarcinoma (PDAC) is a disease of aging. The TP53 gene product regulates cell growth, aging, and cancer. To determine the important targets of TP53 in PDAC, we examined the expression of 440 proteins on a reverse phase protein array (RPPA) in PDAC-derived MIA-PaCa-2 cells which either had WT-TP53 or lacked WT-TP53. MIA-PaCa-2 cells have a TP53 mutation as well as mutant KRAS and represent a good in vitro model to study PDAC. RPPA analysis demonstrated expression of tumor promoting proteins in cells that lacked WT-TP53; and this feature could be reversed significantly when the cells were transfected with vector encoding WT-TP53 or treated with berberine or a modified berberine (BBR). Expression of miR-34a-associated signaling was elevated in cells expressing WT-TP53 compared to cells expressing mTP53. Results from in vivo studies using human PDAC specimens confirmed the in vitro results as the expression of miR-34a and associated signaling was significantly decreased in PDAC specimens compared to non-cancerous tissues. This study determined SERPINE1 as a miR-34a target with relevance to the biology of PDAC. Thus, we have identified a key target (SERPINE1) of the TP53/miR-34a axis that may serve as a potential biomarker for early detection of pancreatic cancer.

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作者列表:["Kou L","Huang H","Lin X","Jiang X","Bao S","Luo Q","Sun J","Yao Q","Ganapathy V","Chen R"]

METHODS::Background: SLC6A14 (ATB0,+), a Na+/Cl-coupled transporter for neutral/cationic amino acids, is overexpressed in many cancers; It has been investigated as a target for improved liposomal drug delivery to treat liver cancer.Research design and methods: Here we explored the mechanism of ATB0,+-mediated entry of such liposomes. As ATB0,+ is highly-expressed in pancreatic cancer, we also examined the therapeutic utility of ATB0,+-targeted liposomal drug delivery to treat this cancer.Results: The uptake of lysine-conjugated liposomes (LYS-LPs) was greater in ATB0,+-positive MCF7 cells. The uptake process consisted of two steps: binding and internalization. The binding of LYS-LPs to MCF7 cells was higher than that of bare liposomes, and the process was dependent on Na+ and Cl-, and inhibitable by ATB0,+ substrates or blocker. In contrast, the internalization step was independent of lysine. The cellular entry of LYS-LPs facilitated by ATB0,+ occurred via endocytosis with transient endosomal degradation of ATB0,+ protein with subsequent recovery. Moreover, LYS-LPs also enhanced the uptake and cytotoxicity of gemcitabine in these cells in an ATB0,+-dependent manner.Conclusions: We conclude that ATB0,+ could be exploited for targeted drug delivery in the form of lysine-conjugated liposomes and that the approach represents a novel strategy for enhanced pancreatic cancer therapy.

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作者列表:["Okada KI","Kawai M","Hirono S","Kojima F","Tanioka K","Terada M","Miyazawa M","Kitahata Y","Iwahashi Y","Ueno M","Hayami S","Murata SI","Shimokawa T","Yamaue H"]

METHODS:PURPOSE:Pre-operative prediction of histological response to neoadjuvant therapy aids decisions regarding surgical management of borderline resectable pancreatic cancer (BRPC). We elucidate correlation between pre-/post-treatment whole-tumor apparent diffusion coefficient (ADC) value and rate of tumor cell destruction. We newly verify whether post-treatment ADC value at the site of vascular contact predicts R0 resectability of BRPC. METHODS:We prospectively reviewed 28 patients with BRPC who underwent diffusion-weighted magnetic resonance imaging before neoadjuvant chemotherapy and surgery. Correlation between the percentage of tumor cell destruction and various parameters was analyzed. Strong parameters were assessed for their ability to predict therapeutic histological response and R0 resectability. RESULTS:Pre-/post-treatment whole-tumor ADC value correlated with tumor cell destruction rate by all parameters (R = 0.630/0.714, P  50% was determined at 1.40 × 10-3 mm2/s. It predicts histological response with 100% sensitivity, 81% specificity, and 89% accuracy. It predicts R0 with 88% sensitivity, 70% specificity, and 75% accuracy. CONCLUSIONS:Post-treatment whole-tumor ADC value may be a predictor of R0 resectability in patients with BRPC. Tumor cell destruction rate is indicated by the difference between pre-/post-treatment ADC values. This difference is strongly affected by the pre-treatment ADC value. The cutoff value of ADC at the site of vascular contact could not discriminate R0 resectability.

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