The p-STAT3/ANXA2 axis promotes caspase-1-mediated hepatocyte pyroptosis in non-alcoholic steatohepatitis.

BACKGROUND: To explore the roles of Annexin A2 (ANXA2) on hepatocyte pyroptosis and hepatic fibrosis in nonalcoholic steatohepatitis (NASH) and underlying molecular mechanism. METHODS: Bioinformatics analyses were performed on transcriptome data of liver tissues from mice and patients with liver fibrosis for screening the hepatocyte pyroptosis-related differential genes. The in vivo NASH mouse model and in vitro NASH cellular model were established. The expression levels of Anxa2/ANXA2 were quantified. Then, the upstream transcription factor of Anxa2 was screened by ChIP-Seq and experimentally verified. The effects of the p-STAT3/ANXA2 axis on Caspase-1 mediated pyroptosis and fibrosis were explored by in vivo and in vitro experiments. RESULTS: Bioinformatics analyses suggested that the expression of Anxa2/ANXA2 was significantly up-regulated in liver tissues of both NASH mice and patients scoring with high pyroptotic activity. Experimental data showed that the ANXA2 expression was positively associated with the development of hepatocyte pyroptosis and fibrosis. As a transcription factor of ANXA2, p-STAT3 can bind to the promoter of Anxa2 and promote its transcription. The inhibition of p-STAT3 can significantly suppress hepatocyte pyroptosis and fibrosis, which was significantly reversed after the over-expression of Anxa2. Caspase-1 was verified as the player of the p-STAT3/ANXA2 axis to promote pyroptosis and fibrosis. By specifically inhibiting Caspase-1, the promotion effect of the p-STAT3/ANXA2 axis on pyroptosis and fibrosis can be significantly weakened. CONCLUSION: The p-STAT3 promoted Anxa2 expression at the transcription level, thus activating the Caspase-1 mediated hepatocyte pyroptosis and fibrosis in NASH.

Expanded CD14hiCD16- Immunosuppressive Monocytes Predict Disease Severity in Patients with Acute Pancreatitis.

Mild acute pancreatitis (AP) is a self-limiting disease, whereas severe AP has high mortality because of enhanced systemic inflammation and multiple organ failure. In experimental models of AP, infiltration of monocytes and activation of monocyte-derived macrophages largely determine the severity of the disease. Our previous studies have shown that CD11b+Ly-6Chi inflammatory monocytes were mobilized from bone marrow into peripheral blood and inflamed pancreas during the early stage of AP. However, the phenotype and characteristics of circulating monocytes in patients with AP are not well defined. Fifty patients with AP and nine age- and sex-matched healthy volunteers were enrolled in this study. Compared with those of healthy volunteers, the proportion of CD14hiCD16- monocytes and the level of myeloid-related cytokines/chemokines were increased in AP patients within 48 h after disease onset, especially in patients with a severe disease course. Moreover, the increased monocyte proportions were associated with decreased HLA-DR expression and a reduced T cell count. Notably, dynamic changes in circulating CD14hiCD16- monocytes and their HLA-DR expression, as well as in CD4+ T cells, were obviously different between moderate severe AP and severe AP. Last, area under the receiver operating characteristic analysis showed that the combination of CD14hiCD16- monocyte proportions with their HLA-DR level had higher accuracy for predicting the severity of AP. Taken together, the ratio of CD14hiCD16- monocytes and their HLA-DR level might assist in predicting the severity of disease in AP patients at admission and in monitoring patients' clinical status during recovery.

Carbon Monoxide Impairs CD11b+Ly-6Chi Monocyte Migration from the Blood to Inflamed Pancreas via Inhibition of the CCL2/CCR2 Axis.

Acute pancreatitis (AP) is a sterile inflammation, in which inflammatory monocytes (CD11b+Ly-6Chi) are recruited into the inflamed tissue at the onset of disease. Monocyte infiltration and activation at the site of inflammation are critical to the pathogenesis of AP. Our previous studies have shown a protective role for CO in AP, which is partially mediated by inhibition of macrophage activation via TLR4 signaling. In the current study, to gain a better understanding of CO's therapeutic effect, we further investigated whether CO could affect inflammatory monocyte trafficking during AP. In a mouse model of AP, we found that treatment with CO-releasing molecule-2 (CORM-2) impaired recruitment of inflammatory monocytes, but not that of neutrophils, from peripheral blood to inflamed pancreas. During the early stage of AP, a single dose of CORM-2 decreased pancreatic CCL2 and soluble ICAM-1 expression. In addition, using in vivo and in vitro experiments, we found that CORM-2 had the ability to inhibit CD11b+Ly-6Chi monocyte migration via blockade of CCR2 endocytosis. Notably, we showed that CORM-2 inhibited CCR2 endocytosis of inflammatory monocytes (CD14hiCD16-) from AP patients. Taken together, our results highlighted CO's effect on inflammatory monocyte trafficking, shedding additional light on its therapeutic potential in AP.

Fluorinated hydrogel nanoparticles with regulable fluorine contents and T2 relaxation times as 19F MRI contrast agents.

Medical imaging contrast agents that are able to provide detailed biological information have attracted increasing attention. Among the new emerging imaging contrast agents, 19F magnetic resonance imaging contrast agents (19F MRI CAs) are extremely promising for their weak background disturbing signal from the body. However, to prepare 19F MRI CAs with a long T2 relaxation time and excellent biocompatibility in a simple and highly effective strategy is still a challenge. Herein, we report a new type of 19F MRI hydrogel nanocontrast agents (19F MRI HNCAs) synthesized by a surfactant-free emulsion polymerization with commercial fluorinated monomers. The T2 relaxation time of 19F MRI HNCA-1 was found to be 25-40 ms, guaranteeing its good imaging ability in vitro. In addition, according to an investigation into the relationship between the fluorine content and 19F MRI signal intensity, the 19F MRI signal intensity was not only determined by the fluorine content in 19F MRI HNCAs but also by the hydration microenvironment around the fluorine atoms. Moreover, 19F MRI HNCAs demonstrated excellent biocompatibility and imaging capability inside cells. The primary exploration demonstrated that 19F MRI HNCAs as a new type of 19F MRI contrast agent hold potential for imaging lesion sites and tracking cells in vivo by 19F MRI technology.

Holmium (III)-doped multifunctional nanotheranostic agent for ultra-high-field magnetic resonance imaging-guided chemo-photothermal tumor therapy.

Ultra-high-field (UHF) MRI has shown great advantages over low-field magnetic resonance imaging (MRI). Despite being the most commonly used MRI contrast agents, gadolinium chelates perform poorly in high magnetic fields, which significantly weakens their T1 intensity. In comparison, the rare element Holmium (Ho)-based nanoparticles (NPs) have demonstrated great potential as T2-weighted MRI contrast agents in UHF MRI due to their extremely short electron relaxation times (∼ 10-13s). In this study, a multifunctional nanotherapeutic probe was designed for UHF MRI-guided chemotherapy and photothermal therapy. The Ho (III)-doped mesoporous polydopamine (Ho-MPDA, HM) nanosphere was loaded with the chemotherapeutic drug mitoxantrone (MTO) and then coated with 4T1 cell membranes to enhance active targeting delivery to breast cancer. The prepared nanotherapeutic probe MTO@HMM@4T1 (HMM@T) exhibited good biocompatibility, high drug-loading capability and great potential as Ho (III)-based UHF MRI contrast agents. Moreover, the biodegradation of HMM@T in response to the intratumor pH and glutathione (GSH) promotes MTO release. Near-infrared (NIR) light irradiation of HM induced photothermal therapy and further enhanced drug release. Consequently, HMM@T effectively acted as an MRI-guided tumor-targeting chemo-photothermal therapy against 4T1 breast cancer. STATEMENT OF SIGNIFICANCE: Ultra-high-field (UHF) MRI has shown great advantages over low-field magnetic resonance imaging (MRI). Although gadolinium chelates are the most commonly used MRI contrast agents in clinical practice, they exhibit a significantly decreased T1 relaxivity at UHF. Holmium exhibits outstanding UHF magnetic resonance capabilities in comparison with gadolinium chelates currently used in clinic. Herein, a theranostic nanodrug (HMM@T) was designed for UHF MRI-guided chemo-photothermal therapy. The nanodrug possessed remarkable UHF T2 MRI properties (r2 = 152.13 mM-1s-1) and high drug loading capability of 18.4 %. The biodegradation of HMM@T NPs under triple stimulations of pH, GSH, and NIR led to an efficient release of MTO in tumor microenvironment. Our results revealed the potential of a novel UHF MRI-guided multifunctional nanosystem in cancer treatment.

Ketogenesis acts as an endogenous protective programme to restrain inflammatory macrophage activation during acute pancreatitis.

BACKGROUND: Innate immunity and metabolites link to the pathogenesis and severity of acute pancreatitis (AP). However, liver metabolism and its role in immune response and AP progression remain elusive. We investigated the function of liver metabolism in the pathogenesis of AP. METHODS: Circulating ketone body ß-hydroxybutyrate (ßOHB) levels were determined in AP clinical cohorts and caerulein-induced AP (CER-AP) mouse models receiving seven (Cer*7) or twelve (Cer*12) injection regimens at hourly intervals. Liver transcriptomics and metabolomics were compared between CER-AP (Cer*7) and CER-AP (Cer*12). Inhibition of fatty acid ß-oxidation (FAO)-ketogenesis, or supplementation of ßOHB was performed in mouse models of AP. The effect and mechanism of ßOHB were examined in vitro. FINDINGS: Elevated circulating ßOHB was observed in patients with non-severe AP (SAP) but not SAP. These findings were replicated in CER-AP (Cer*7) and CER-AP (Cer*12), which manifested as limited and hyperactive immune responses, respectively. FAO-ketogenesis was activated in CER-AP (Cer*7), while impaired long-chain FAO and mitochondrial function were observed in the liver of CER-AP (Cer*12). Blockage of FAO-ketogenesis (Cpt1a antagonism or Hmgcs2 knockdown) worsened, while supplementation of ßOHB or its precursor 1,3-butanediol alleviated the severity of CER-AP. Mechanistically, ßOHB had a discernible effect on pancreatic acinar cell damage, instead, it greatly attenuated the activation of pancreatic and systemic proinflammatory macrophages via class I histone deacetylases. INTERPRETATION: Our findings reveal that hepatic ketogenesis is activated as an endogenous protective programme to restrain AP progression, indicating its potential therapeutic value. FUNDING: This work was supported by the National Natural Science Foundation of China, Shanghai Youth Talent Support Programme, and Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant.

A Positive Feedback Loop of TET3 and TGF-ß1 Promotes Liver Fibrosis.

Pathological activation of TGF-ß signaling is universal in fibrosis. Aberrant TGF-ß signaling in conjunction with transdifferentiation of hepatic stellate cells (HSCs) into fibrogenic myofibroblasts plays a central role in liver fibrosis. Here we report that the DNA demethylase TET3 is anomalously upregulated in fibrotic livers in both humans and mice. We demonstrate that in human HSCs, TET3 promotes profibrotic gene expression by upregulation of multiple key TGF-ß pathway genes, including TGFB1. TET3 binds to target gene promoters, inducing demethylation, which in turn facilitates chromatin remodeling and transcription. We also reveal a positive feedback loop between TGF-ß1 and TET3 in both HSCs and hepatocytes. Furthermore, TET3 knockdown ameliorates liver fibrosis in mice. Our results uncover a TET3/TGF-ß1 positive feedback loop as a crucial determinant of liver fibrosis and suggest that inhibiting TET3 may represent a therapeutic strategy for liver fibrosis and perhaps other fibrotic diseases.

Colloid properties of hydrophobic modified alginate: Surface tension, ζ-potential, viscosity and emulsification.

Micelle properties of hydrophobic modified alginate (HM-alginate) in various dispersion media have been studied by surface tension, ζ-potential, and viscosity measurements. Effect of salt on micelle properties showed that the presence of counter ion weakened the repulsive interaction between surfactant ions, decreased the critical micelle concentration (CMC) value of the HM-alginate, reduced the effective volume dimensions of HM-alginate and hence viscosity, which coincide with the corresponding ζ-potential values. Soy oil-in-water emulsions, stabilized solely by HM-alginate, were produced in high speed homogenization conditions and their stability properties were studied by visual inspection, optical microscopy and droplet size measurements. The results showed that emulsions (oil-water ratio was 1:7) containing 15mg/mL HM-alginate presented better stability during 15days storage, which stating clearly that HM-alginate is an effective emulsifier to stabilize oil-in-water emulsions. The herein presented homogeneous method for preparation of emulsion has the potential to be used in food industry.

Elevated hepatic expression of H19 long noncoding RNA contributes to diabetic hyperglycemia.

Excessive hepatic glucose production (HGP) contributes significantly to the hyperglycemia of type 2 diabetes; however, the molecular mechanism underlying this dysregulation remains poorly understood. Here, we show that fasting temporally increases the expression of H19 long noncoding RNA (lncRNA) in nondiabetic mouse liver, whereas its level is chronically elevated in diet-induced diabetic mice, consistent with the previously reported chronic hepatic H19 increase in diabetic patients. Importantly, liver-specific H19 overexpression promotes HGP, hyperglycemia, and insulin resistance, while H19 depletion enhances insulin-dependent suppression of HGP. Using genome-wide methylation and transcriptome analyses, we demonstrate that H19 knockdown in hepatic cells alters promoter methylation and expression of Hnf4a, a master gluconeogenic transcription factor, and that this regulation is recapitulated in vivo. Our findings offer a mechanistic explanation of lncRNA H19's role in the pathogenesis of diabetic hyperglycemia and suggest that targeting hepatic H19 may hold the potential of new treatment for this disease.

Dopamine D2 receptor signalling controls inflammation in acute pancreatitis via a PP2A-dependent Akt/NF-κB signalling pathway.

BACKGROUND AND PURPOSE: Dopamine has multiple anti-inflammatory effects, but its role and molecular mechanism in acute pancreatitis (AP) are unclear. We investigated the role of dopamine signalling in the inflammatory response in AP. EXPERIMENTAL APPROACH: Changes in pancreatic dopaminergic system and effects of dopamine, antagonists and agonists of D1 and D2 dopamine receptors were analysed in wild-type and pancreas-specific Drd2-/- mice with AP (induced by caerulein and LPS or L-arginine) and pancreatic acinar cells with or without cholecystokinin (CCK) stimulation. The severity of pancreatitis was assessed by measuring serum amylase and lipase and histological assessments. The NF-κB signalling pathway was evaluated, and macrophage and neutrophil migration assessed by Transwell assay. KEY RESULTS: Pancreatic dopamine synthetase and metabolic enzyme levels were increased, whereas D1 and D2 receptors were decreased in AP. Dopamine reduced inflammation in CCK-stimulated pancreatic acinar cells by inhibiting the NF-κB pathway. Moreover, the protective effects of dopamine were blocked by a D2 antagonist, but not a D1 antagonist. A D2 agonist reduced pancreatic damage and levels of p-IκBα, p-NF-κBp65, TNFα, IL-1ß and IL-6 in AP. Pancreas-specific Drd2-/- aggravated AP. Also, the D2 agonist activated PP2A and inhibited the phosphorylation of Akt, IKK, IκBα and NF-κB and production of inflammatory cytokines and chemokines. Furthermore, it inhibited the migration of macrophages and neutrophils by reducing the expression of CCL2 and CXCL2. A PP2A inhibitor attenuated these protective effects of the D2 agonist. CONCLUSIONS AND IMPLICATIONS: D2 receptors control pancreatic inflammation in AP by inhibiting NF-κB activation via a PP2A-dependent Akt signalling pathway.

Effects of angiotensin II receptor antagonist, Losartan on the apoptosis, proliferation and migration of the human pancreatic stellate cells.

AIM: To investigate the effects of AT1 (Type 1 angiotensin II receptor) antagonist (Losartan) on the apoptosis, proliferation and migration of the human pancreatic stellate cells (hPSCs). METHODS: hPSCs were isolated from pancreatic sample of patients with pancreatic carcinoma using radioimmunoassay (RIA) technique to detect the concentration of AngII in culture media and cell homogenate. Immunocytochemistry (ICC) and in situ hybridization (ISH) methods were utilized to test AT1 expression in hPSCs. Effects of Losartan on hPSCs proliferation, apoptosis and migration were investigated using BrdU incorporation, TUNEL, flow cytometry (FCM), and phase-contrast microscope separately when cells treated with Losartan. Immunofluorescence and Western blot were applied to quantify the expression of type I collagen in hPSCs. RESULTS: There exists AT1 expression in hPSCs, while no AngII was detected in culture media and cell homogenate. Losartan induces cell apoptosis in a dose- and time-dependent manner (apparently at 10(-5) mol/L), no pro-proliferative effect was observed in the same condition. Corresponding dosage of Losartan can also alleviate the motion capability and type I collagen content of hPSCs compared with AngII treatment and non-treatment control groups. CONCLUSION: These findings suggest that paracrine not autocrine functions of AngII may have effects on hPSCs, which was mediated by AT1 expressed on cells, while Losartan may exert anti-fibrotic effects by inhibiting hPSCs motion and partly by inducing apoptosis.

Cholangiographic features and endoscopic treatment of biliary strictures.

OBJECTIVES: The most commonly occurring complications following orthotopic liver transplantation procedures are associated with the biliary tract. Endoscopic technique has become the primary modality for the treatment of biliary strictures after liver transplantation. The objective of this study was to assess the role of cholangiographic features of the initial cholangiogram in endoscopic treatment success and stricture recurrence. METHODS: Patients who underwent endoscopic therapy for biliary strictures after orthotopic liver transplantation (OLT), from 2006 to 2009 were included in this retrospective study. RESULTS: The initial success rate after endoscopic treatment was achieved in 85.53% patients. However, recurrence of biliary strictures occurred in 24.62% of the patients. Patients with successful anastomotic biliary strictures (AS) after treatment were characterized by shorter stricture length as compared to patients who have not achieved success (p < 0.01). Of the 42 patients with AS, patients with recurrence had larger initial stricture length (p < 0.01) and smaller narrowing diameter (p < 0.01) than those without recurrence. Patients treated with NAS for multiple strictures experienced increased rate of recurrence than those with single narrowing, but failed to achieve statistical significance (50% vs. 23.08%, p = 0.18). Patients for whom dilation failed to eliminate the waist, experienced higher recurrence rate than those without stricture waist (70% vs. 16.63%, p < 0.01). CONCLUSIONS: Endoscopic procedure using endoscopic retrograde cholangiopancreatography was found to be an effective modality for treating biliary strictures after OLT.

[Regulatory effects of peroxisome proliferator-activated receptor gamma on the growth of pancreatic carcinoma].

OBJECTIVE: To examine the effects of peroxisome proliferator-activated receptor (PPAR)gamma activation on the growth of human pancreatic carcinoma both in vitro and in vivo. METHODS: The expression of PPARgamma and RXRalpha were examined by RT-PCR. SW1990 pancreatic cancer cells were treated with 9-cis-RA, ligand of PPARgamma, 15d-PGJ(2), and both. Antiproliferative effect was evaluated with cell viability by using MTT assay. Pancreatic cancer xenograft tumor model was established in nude mice by inoculating SW1990 cells subcutaneously and rosiglitazone, a PPARgamma activator, was administered via water drinking in experimental group. The nude mice were sacrificed after 75 days, the volume and weight of the xenograft tumor were measured. Expression of PCNA was observed by immunohistochemical staining. RESULTS: RT-PCR showed that PPARgamma and RXRalpha mRNA were expressed in SW1990 cell line. MTT assay demonstrated that 15d-PGJ(2), 9-cis-RA and the combination of both had a potent inhibitory effect on the growth of SW1990 cells with a dose-dependent manner. SW1990 cells were suppressed to more than 50% of the control at the concentration of 10 micro mol/L 15d-PGJ(2), 20 micro mol/L 9-cis-RA and 5 micro mol/L 15d-PGJ(2) plus 10 micro mol/L 9-cis-RA, respectively. 9-cis-RA had a synergic action with 15d- PGJ(2) on the growth inhibition of pancreatic carcinoma. In vivo studies, rosiglitazone suppressed the growth of pancreatic carcinoma in a statistically significant manner (P < 0.05). The average tumor volume and tumor weight in the experimental group were less than those in the control group, the growth inhibition rate of rosiglitazone was 80.7%. PCNA was present in both groups, but immunohistochemistry showed a down-regulation trend of PCNA in the experimental group as compared with the control group. CONCLUSIONS: Activation of PPARgamma exerts a negative regulatory effect on the growth of pancreatic carcinoma both in vitro and in vivo. These results suggest that PPARgamma might be a novel therapeutic target for the pancreatic carcinoma. Activation of RXRalpha has a synergic action with PPARgamma agonist on the growth inhibition of pancreatic carcinoma.

[The role of lipopolysacchride-binding protein in the pathogenesis of animal model of acute necrotizing pancreatitis].

OBJECTIVE: To explore the pathogenic role of lipopolysacchride-binding protein (LBP) in the pathogenesis of acute necrotizing pancreatitis (ANP) by applying anti-LBP antibody to the animal model of ANP in mice. METHODS: Sixty BALB/c mice were randomly divided into four groups, including ANP group (n = 18), ANP treated with anti-LBP antibody group (n = 18), anti-LBP antibody group (n = 18) and normal control (n = 6). ANP model was induced by seven times administration of cerulein (50 micro g/kg.body weight), challenged by lipopolysaccharide (LPS) (5 mg/kg) intravenous injection. Treatment with anti-LBP antibody was started 15 minutes before LPS injection in ANP treated with anti-LBP antibody group. Anti-LBP antibody group only received intravenous injection of anti-LBP antibody, normal saline was administrated intraperitoneally instead of cerulein and LPS. At 9 h, 12 h and 24 h after the first injection of cerulein (or saline), the serum levels of amylase and lactate dehydrogenase (LDH) were measured. The severity of pancreatitis was evaluated by histological scoring system. Intrapancreatic TNF-alpha, IL-1beta, ICAM-1 and E-selectin mRNA expressions were studied by semi-quantitative RT-PCR. The activation of nuclear factor-kappaB (NF-kappaB) in the pancreas was investigated by the methods of immunohistochemistry and Western blot. The activity of PMN myeloperoxidase (MPO) was determined by zymohistochemistry. RESULTS: Compared with the ANP group, a marked elevation of serum amylase was observed 9 h and 12 h after cerulein administration and a marked elevation of serum LDH was observed 24 h after cerulein administration in the ANP treated with anti-LBP antibody group. Histologically, treatment with anti-LBP group increased the severity of pancreatic injury including edema at 9 h and 12 h after, and inflammatory cell infiltration and necrosis 24 h after. Intrapancreatic TNF-alpha, IL-1beta, ICAM-1 and E-selectin mRNA levels were increased. The activity of MPO was increased significantly 12 h and 24 h after in the anti-LBP antibody group. Immunohistochemistry and Western blotting showed up-regulation of NF-kappaB. However, there was no significant difference in serum parameters and pathologic scoring results between LBP antibody group and normal control. CONCLUSION: LBP plays a protective role in the pathogenesis of ANP, and this action may be mediated by inhibiting of NF-kappaB activation and down-regulation of proinflammatory mediators.

[Inhibition of angiogenesis in pancreatic carcinoma by cyclooxygenase-2 antisense oligodeoxynucleotides].

OBJECTIVE: To investigate the effect of cyclooxygenase-2 antisense oligodeoxynucleotides (COX-2 AS-ODNs) on the angiogenesis in pancreatic carcinoma and to evaluate the intermediary effect of prostaglandin 2 in this process. METHODS: Specific targeting COX-2 AS-ODNs were designed and synthesized, and transfected into the PC3 human pancreatic carcinoma cells cultured in vitro. Fluorescence microscopy was used to observe the PC3 cells 0.12. 24, 40, and 72 hours after the transfection. the second cultured PC3 cells were divided into 5 groups: control group, Lipo group (transfected with Lipofectin only), C1 group (transfected with 1 micro g COX-2 AS-ODN + Lipo/well), C2 group (transfected with 2 micro g COX-2 AS-ODN + Lipo/well), and C3 group (transfected with 3 micro g COX-2 AS-ODN + Lipo/well). RT-PCR was used to observe the expression of COX-2 mRNA in the PC3 cells. The third batch of PC3 cells were transfected with 3 micro g COX-2 AS-ODN + Lipo/well, and the expression of COX-2 mRNA was observed 0, 12, 24, 48, and 72 hours later by RT-PCR. 3 micro g COX-2 AS-ODN + Lipo/bottle and 9 micro g COX-2 AS-ODN + Lipo/bottle were added into the cultured PC3 cells and Western blotting was used to observe the expression of COX-2 protein 24 hours later. 24 chicken eggs were inoculated with PC3 cells into the chorio-allantoic membrane and then divided equally into 5 groups; control group, Lipo group, COX-2 AS-ODN + Lipo group, and COX-2 AS-ODN + Lipo + PGE2 group. Leica microscopy was used to observe the angiogenesis in the transplanted carcinoma. RESULTS: RT-PCR showed that the downregulation of expression of COX-2 mRNA in the PC3 cells with the increase of the COX-2 AS-ODN concentration, peaking at the concentration of 0.2 micro mol/L. The effect of COX-2 AS-ODN was strongest by the 12th hour after transfection and then began to decrease and basically disappeared 48 hours after. Western blotting showed that COX-2 AS-ODN, especially that of the concentration of the expression of 9 micro g/bottle, inhibited the expression of COX-2 AS-ODN. The angiogenesis of the transplanted carcinoma in the eggs was significantly inhibited in the Lipo + COX-2 AS-ODN group, the density of newly generated vessels in the Lipo + COX-2 AS-ODN + PGE2 group was between those of the other 2 groups. CONCLUSION: COX-2 AS-ODN significantly inhibits the angiogenesis in the pancreatic carcinoma. Endogenous COX-2 AS-ODN may play an important role in such a process and PGE2 may play an intermediate role therein.

Comparison of the safety and effectiveness of endoscopic biliary decompression by nasobiliary catheter and plastic stent placement in acute obstructive cholangitis.

BACKGROUND: Endoscopic retrograde biliary drainage (ERBD) using a plastic stent is suggested to be as effective as endoscopic nasobiliary drainage (ENBD) with a nasobiliary catheter for temporary biliary drainage in acute obstructive cholangitis. However, there are few studies that have compared the two methods. We therefore compared the safety and effectiveness of endoscopic biliary decompression by nasobiliary catheter versus plastic stent placement in these patients. METHODS: A total of 94 screened patients with acute obstructive cholangitis were randomised to undergo emergency endoscopic biliary drainage with ENBD (n = 47) or ERBD (n = 47). Clinical outcomes and adverse events were compared. RESULTS: Patient backgrounds were similar in the two groups. Endoscopic biliary drainage was successfully achieved in all patients. Eleven patients underwent unscheduled endoscopic retrograde cholangiopancreatography (ERCP) to replace the nasobiliary catheter, 10 due to a catheter (1 in the ENBD group) or stent (9 in the ERBD group) blockage and 1 due to catheter migration. Clinical manifestations were similar, however, there was a significantly lower patient discomfort score in the ERBD group (p <0.05). The mean serum gamma-glutamyltransferase and total bilirubin concentrations after ERCP were significantly higher in the ERBD than ENBD group (p <0.001). Complication rates were similar in the ENBD and ERBD groups. However, the incidence rate of blockage in ERBD was statistically higher than ENBD (p = 0.015). CONCLUSIONS: Endoscopic biliary decompression is an effective treatment for patients with acute obstructive cholangitis. In contrast to other studies, we found an increased rate of blockage in the ERBD group and a greater decrease in liver enzyme levels in the ENBD group.

Roles of endotoxin-related signaling molecules in the progression of acute necrotizing pancreatitis in mice.

OBJECTIVE: To study the potential roles of lipopolysaccharide (LPS) signaling molecules, LPS-binding protein (LBP), CD14, and Toll-like receptor 4 (TLR4) in mice with acute necrotizing pancreatitis (ANP). METHODS: The ANP model was made by 7 intraperitoneal injections of cerulein (50 mug/kg) at hourly intervals, challenged by LPS administration of a dose of 5 mg/kg intraperitoneally 5 hours after the first injection of cerulein. Fifty-nine Balb/C mice were divided into 4 groups: group A, ANP control group, n = 18, received physiological saline; group B, anti-LBP group, n = 18, received 200 mug anti-LBP antibody; group C, anti-CD14 group, n = 18, received 20 microg anti-CD14 antibody; group D, anti-TLR4 group, n = 5, received 20 mug anti-TLR4 antibody. All treatments were given at 15 minutes before LPS injection. Serum amylase and lactic dehydrogenase (LDH) were measured. Histologic alteration of the pancreas was evaluated. Expressions of tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), and intercellular adhesion molecular (ICAM-1) mRNA were determined using reverse transcription polymerase chain reaction (RT-PCR). Myeloperoxidase (MPO) activity in pancreas was also analyzed. Nuclear factor-kappaB (NF-kappaB) p65 subunit was measured by immunohistochemistry and Western blotting. RESULTS: Pretreatment of animals with anti-CD14 antibody resulted in a significant decrease in serum amylase and LDH levels, reduction of the severity of pancreatic injury, down-regulation of TNF-alpha, IL-1beta, and ICAM-1 mRNA expression, decrease in pancreatic MPO activity, and decrease in NF-kappaB expression compared with ANP control mice. In contrast, mice pretreated with anti-LBP antibody or anti-TLR4 antibody resulted in increasing of serum amylase and LDH levels, aggravation of the severity of necrosis and inflammation in pancreas, up-regulation of TNF-alpha, IL-1beta, and ICAM-1 mRNA expression, increasing of pancreatic MPO activity, and up-regulation of NF-kappaB expression compared with ANP control mice. CONCLUSIONS: (1) LBP per se possesses a protective effect on ANP. It could facilitate clearance of endotoxin. (2) CD14 plays a crucial intermediate role in the progression of ANP. (3) TLR4, the essential transducer of LPS responses, may act independently of LPS. The antibody against TLR4 may mimic endotoxin and induce activation of downstream cytokines. For implication, recombinant LBP, anti-CD14 antibody, or silent TLR4 might alleviate the progression of ANP.

Angiotensin II mediates acinar cell apoptosis during the development of rat pancreatic fibrosis by AT1R.

OBJECTIVES: The mechanisms of pancreatic fibrosis were not fully elucidated. Apoptosis has been suggested to be involved in the progression of pancreatic fibrosis. It has been reported that the renin-angiotensin system (RAS) plays a crucial role in the formation of fibrosis, including in the kidney, heart, and liver. We recently reported that the angiotensin II type I receptor (AT1R) antagonist losartan has been able to alleviate the pancreatic fibrosis in the rat model, indicating angiotensin II participated in the progression of pancreatic fibrosis. In present study, the possible effects of angiotensin II-mediated apoptosis of pancreatic acinar cells were investigated in rat pancreatic fibrosis induced by trinitrobenzene sulfonic acid (TNBS) by AT1R, with special reference to the losartan administration. METHODS: Male Sprague-Dawley rats (200-300 g) were randomly divided into a normal group, a control group, and a losartan-treatment group. Pancreatic fibrosis was induced by infusion of 2% TNBS into the pancreatic duct. Rats were treated with losartan (10 mg/kg) by gavage daily in the losartan-treatment group and the same volume of sterile distilled water was administered to the control group. All treatments started on the first day and ended 8 weeks after the operation. On day 3 and at weeks 1, 2, 3, 4, and 8, the histologic changes of the pancreas were examined by hematoxylin and eosin staining, and pancreatic acinar cell apoptosis was investigated by using electron microscopy and terminal deoxynucleotidyl transferase UTP nick end labeling (TUNEL), indicated by the apoptotic index (AI). Expressions of Bax, Bak, and Bcl-2 mRNA in the pancreas were detected by reverse transcriptase polymerase chain reaction (RT-PCR) on day 3 and at weeks 1, 2, 3, and 4. RESULTS: Compared with the control group, losartan treatment significantly alleviated the histologic abnormalities, including infiltration of inflammatory cells and acinar cells atrophy. In the control group, a typical morphologic presentation of acinar cell apoptosis was seen either with electron microscopy or TUNEL staining. The AI was increased in pancreatic tissue. Meanwhile, Bax and Bak mRNA expression was increased, but Bcl-2 mRNA expression was decreased, as compared with the normal group. The administration of losartan resulted in inhibition of acinar cell apoptosis and down-regulation of Bax, Bak, and Bcl-2 mRNA expression. The Bax/Bcl-2 ratio was lower in losartan-treated rats than in control rats. CONCLUSION: Losartan prevents apoptosis of pancreatic acinar cell by blocking AT1R during the development of pancreatic fibrosis. This action may be associated with its regulation of apoptosis-associated genes, such as Bax, Bak, and Bcl-2 mRNA. The results of present study suggest that angiotensin II probably mediates pancreatic acinar cell apoptosis during the course of pancreatic fibrosis.