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1.
Khirurgiia (Mosk) ; (1): 47-54, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33395512

RESUMO

OBJECTIVE: To analyze the effect of timing of surgery, quality of resection and removal of MPD-stones on long-term results of duodenum-preserving pancreatic head resection (DPPHR). MATERIAL AND METHODS: The study included 110 patients with chronic pancreatitis (CP) who underwent DPPHR in 2014-2019. Evaluation of long-term outcomes included pain syndrome severity, exocrine and endocrine insufficiency and quality of life (QoL). Patients were stratified depending on duration of disease (within 36 months, >36 months after manifestation), volume of resected pancreatic head tissue according to CT data, removal of MPD-stones. RESULTS: Surgical treatment within 36 months after clinical manifestation was followed by less pain syndrome (VAS score 1.16±1.76 vs. 2.03±1.87, p=0.02), exocrine insufficiency (69.8% vs. 98.5%, p<0.001). Resection of more than 50% of the pancreatic head and removal of MPD-stones were accompanied by pain relief, improved pancreatic secretory function and quality of life. CONCLUSION: Pancreatic head resection in patients with chronic pancreatitis should be performed within 3 years after clinical manifestation. Resection of more than 50% of the pancreatic head with extraction of MPD-stones ensures pain relief, better endocrine and exocrine function, as well as higher QoL in long-term follow-up period.


Assuntos
Pâncreas/cirurgia , Pancreatite Crônica , Qualidade de Vida , Cálculos/complicações , Cálculos/cirurgia , Humanos , Pâncreas/diagnóstico por imagem , Pancreatectomia/efeitos adversos , Pancreatectomia/métodos , Ductos Pancreáticos/diagnóstico por imagem , Ductos Pancreáticos/cirurgia , Pancreatite Crônica/complicações , Pancreatite Crônica/diagnóstico por imagem , Pancreatite Crônica/cirurgia , Fatores de Tempo , Resultado do Tratamento
2.
Environ Sci Pollut Res Int ; 28(2): 2209-2218, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32870427

RESUMO

The present study aimed to analyze the impact of tartrazine (T) and crocin (Cr) applications on the pancreas tissues of the Wistar rats. A total of 40 Wistar rats were randomly divided into 4 groups with 10 rats in each group, including the Control, T, Cr, and T + Cr groups. After 3 weeks of application, the pancreatic tissues of the rats were removed under anesthesia and rat blood samples were obtained. Tissues were analyzed with biochemical and histopathological methods. It was determined that T administration increased malondialdehyde (MDA), total oxidant status (TOS), oxidative stress index (OSI), glucose, triglyceride, LDL, VLDL, and total cholesterol levels. However, it decreased reduced glutathione (GSH), total antioxidant status (TAS), superoxide dismutase (SOD), catalase (CAT), and HDL levels when compared with the other groups. It was observed that Cr administration significantly increased GSH, SOD, CAT, TAS, and HDL levels when compared with the control group. In the T group, histopathological changes were observed in pancreatic tissue, leading to damages in exocrine pancreas and islets of Langerhans and increased caspase-3 immunoreactivity (p ≤ 0.001). Co-administration of Cr and T brought the biochemical and histopathological findings closer to the control group levels. The administration of T induced damage in the pancreas with the administered dose and frequency. Cr can increase the antioxidant capacity in pancreas tissue. Co-administration of T and Cr contributed to the reduction of the toxic effects induced by T. It could be suggested that Cr administration ameliorated T toxicity.


Assuntos
Carotenoides , Tartrazina , Animais , Antioxidantes , Catalase/metabolismo , Glutationa/metabolismo , Malondialdeído , Estresse Oxidativo , Pâncreas/metabolismo , Ratos , Ratos Wistar , Superóxido Dismutase/metabolismo
3.
Life Sci ; 264: 118641, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33148420

RESUMO

Pancreatitis is an inflammatory disease of the pancreas characterized by acinar cell injury and is associated with the abnormal release of trypsin, which results in high mortality due to systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). The inflammatory response, impaired autophagic flux, endoplasmic reticulum stress (ERS) and their interactions are involved in the development of pancreatitis. Molecular hydrogen (H2) is a novel antioxidant that possesses the features of selective scavenging of oxygen free radicals and nontoxic metabolites and has been shown to be efficacious for treating infection, injury, tumors, ischemia-reperfusion organ injury, metabolic disease and several other diseases. Recent studies have found that H2 is also useful in the treatment of pancreatitis, which may be related to the mechanism of antioxidative stress, anti-inflammation, anti-apoptosis, regulation of immunity and regulation of molecular pathways. This review focuses on the pathogenesis of pancreatitis and the research progress and potential mechanisms of H2 against pancreatitis to provide theoretical bases for future research and clinical application of H2 therapy for pancreatitis.


Assuntos
Hidrogênio/uso terapêutico , Pancreatite/terapia , Animais , Antioxidantes/metabolismo , Apoptose , Autofagia/efeitos dos fármacos , Morte Celular , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Humanos , Inflamação , Sistema de Sinalização das MAP Quinases , Insuficiência de Múltiplos Órgãos , Estresse Oxidativo , Pâncreas/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Traumatismo por Reperfusão , Síndrome de Resposta Inflamatória Sistêmica/metabolismo , Tripsina/química
5.
J Surg Res ; 257: 605-615, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32947122

RESUMO

BACKGROUND: The clinicopathologic factors associated with the survival of patients with pancreatic ductal adenocarcinoma (PDAC) during the different phases of neoadjuvant treatment (NT)-at diagnosis, restaging, or postoperatively-remain unclear. METHODS: Data of patients with PDAC who underwent pancreatic resection after NT between 2008 and 2018 were retrospectively collected. Clinicopathologic characteristics and outcomes were compared stratified by resection margin status. Three multivariable regression models (at diagnosis, restaging, and postoperatively) were constructed to assess the temporal impact of different prognostic factors on all-cause survival (ACS) and disease-free survival (DFS). RESULTS: All patients were diagnosed with a nonmetastatic PDAC and were appropriate candidates for NT according to the current National Comprehensive Cancer Network guidelines. From a total of 83 patients, 57 (68.7%) had a negative resection margin >1 mm (R0), whereas 26 patients (31.3%) had a positive resection margin (R1). At diagnosis, planned procedure (P = 0.017) and CA19-9 >100 U/mL (P = 0.047) were independent prognostic factors of decreased ACS. At restaging, planned procedure (P = 0.017), FOLFIRINOX (P = 0.026), and tumor size >30 mm (P = 0.030) were independent prognostic factors for increased and decreased ACS, respectively. Postoperatively, R0 was an independent prognostic factor for improved ACS (P = 0.005) and DFS (P = 0.002), whereas adjuvant therapy (P = 0.006) was associated with increased ACS. Lymph node involvement (P = 0.019) was associated with decreased DFS. CONCLUSIONS: At diagnosis, restaging, and postoperatively, different, relevant clinicopathologic factors significantly impact the survival of patients with nonmetastatic PDAC undergoing NT. An R0 resection remains the most important prognostic factor and therefore should be the primary goal of surgical treatment in the neoadjuvant setting.


Assuntos
Carcinoma Ductal Pancreático/mortalidade , Terapia Neoadjuvante , Pancreatectomia , Neoplasias Pancreáticas/mortalidade , Idoso , Boston/epidemiologia , Carcinoma Ductal Pancreático/patologia , Carcinoma Ductal Pancreático/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/patologia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/terapia , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos
6.
Food Chem ; 338: 128113, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33092009

RESUMO

Saponins are promising compounds for ameliorating hyperlipidemia but scarce information exists about sapogenins, the hydrolyzed forms of saponins. Saponin-rich extracts and their hydrolysates from fenugreek (FE, HFE) and quinoa (QE, HQE), and saponin and sapogenin standards, were assessed on the inhibition of pancreatic lipase and interference on the bioaccessibility of cholesterol by in vitro digestion models. All extracts inhibited pancreatic lipase (IC50 between 1.15 and 0.59 mg/mL), although the hydrolysis enhanced the bioactivity of HQE (p = 0.014). The IC50 value significantly correlated to the saponin content (r = -0.82; p = 0.001). Only the hydrolyzed extracts showed a reduction of bioaccessible cholesterol (p < 0.001) higher than that of phytosterols (35% reduction). Sapogenin standards exhibited no bioactivities, protodioscin and hederacoside C slightly inhibited the lipase (around 10%) and protodioscin reduced the bioaccessible cholesterol (23% reduction, p = 0.035). The hydrolysis process of saponin-rich extracts enhances the bioactivity and allows developing multibioactive products against pancreatic lipase and cholesterol absorption simultaneously.


Assuntos
Chenopodium quinoa/química , Lipase/antagonistas & inibidores , Pâncreas/enzimologia , Extratos Vegetais/química , Extratos Vegetais/farmacologia , Saponinas/química , Trigonella/química , Anticolesterolemiantes/química , Anticolesterolemiantes/farmacologia , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Hidrólise
7.
Clin Imaging ; 69: 185-195, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32866771

RESUMO

Simultaneous pancreas-kidney transplant remains a treatment option for patients with insulin-dependent diabetes mellitus type 1, aimed at restoring normoglycemia, alleviating insulin dependency, avoiding diabetic nephropathy, and thereby improving the quality of life. Imaging remains critical in the assessment of these transplant grafts. Ultrasound with Doppler remains the primary imaging modality for establishing baseline assessment of the graft as well as for evaluating vascular, parenchymal, and perigraft complications. Noncontrast MR imaging is preferred over non-contrast CT for evaluation of parenchymal or perigraft complications in patients with decreased renal function, although contrast-enhanced CT/MR imaging may be obtained following multidisciplinary consultation in cases with high clinical and laboratory suspicion for graft dysfunction. Catheter angiography is reserved primarily for therapeutic intervention in suspected or confirmed vascular complications. An understanding of the surgical techniques and imaging appearance of a normal graft is crucial to identify potential complications and direct timely management. This article provides an overview of surgical techniques, normal imaging appearance, as well as the spectrum of imaging findings and potential complications in pancreas-kidney transplants.


Assuntos
Diabetes Mellitus Tipo 1 , Transplante de Rim , Transplante de Pâncreas , Humanos , Transplante de Rim/efeitos adversos , Pâncreas , Transplante de Pâncreas/efeitos adversos , Complicações Pós-Operatórias , Qualidade de Vida
8.
PLoS One ; 15(12): e0239889, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33264294

RESUMO

Laminin N-terminus α31 (LaNt α31) is a netrin-like protein derived from alternative splicing of the laminin α3 gene. Although LaNt α31 has been demonstrated to influence corneal and skin epithelial cell function, its expression has not been investigated beyond these tissues. In this study, we used immunohistochemistry to characterise the distribution of this protein in a wide-array of human tissue sections in comparison to laminin α3. The data revealed widespread LaNt α31 expression. In epithelial tissue, LaNt α31 was present in the basal layer of the epidermis, throughout the epithelium of the digestive tract, and in much of the epithelium of the reproductive system. LaNt α31 was also found throughout the vasculature of most tissues, with enrichment in reticular-like fibres in the extracellular matrix surrounding large vessels. A similar matrix pattern was observed around the terminal ducts in the breast and around the alveolar epithelium in the lung, where basement membrane staining was also evident. Specific enrichment of LaNt α31 was identified in sub-populations of cells of the kidney, liver, pancreas, and spleen, with variations in intensity between different cell types in the collecting ducts and glomeruli of the kidney. Intriguingly, LaNt α31 immunoreactivity was also evident in neurons of the central nervous system, in the cerebellum, cerebral cortex, and spinal cord. Together these findings suggest that LaNt α31 may be functionally relevant in a wider range of tissue contexts than previously anticipated, and the data provides a valuable basis for investigation into this interesting protein.


Assuntos
Rim/metabolismo , Laminina/metabolismo , Fígado/metabolismo , Pâncreas/metabolismo , Baço/metabolismo , Membrana Basal/metabolismo , Epitélio/metabolismo , Matriz Extracelular/metabolismo , Humanos , Imuno-Histoquímica , Neurônios/metabolismo
9.
Nat Commun ; 11(1): 6339, 2020 12 11.
Artigo em Inglês | MEDLINE | ID: mdl-33311482

RESUMO

Ferroptosis is a more recently recognized form of cell death that relies on iron-mediated oxidative damage. Here, we evaluate the impact of high-iron diets or depletion of Gpx4, an antioxidant enzyme reported as an important ferroptosis suppressor, in the pancreas of mice with cerulean- or L-arginine-induced pancreatitis, and in an oncogenic Kras murine model of spontaneous pancreatic ductal adenocarcinoma (PDAC). We find that either high-iron diets or Gpx4 depletion promotes 8-OHG release and thus activates the TMEM173/STING-dependent DNA sensor pathway, which results in macrophage infiltration and activation during Kras-driven PDAC in mice. Consequently, the administration of liproxstatin-1 (a ferroptosis inhibitor), clophosome-mediated macrophage depletion, or pharmacological and genetic inhibition of the 8-OHG-TMEM173 pathway suppresses Kras-driven pancreatic tumorigenesis in mice. GPX4 is also a prognostic marker in patients with PDAC. These findings provide pathological and mechanistic insights into ferroptotic damage in PDAC tumorigenesis in mice.


Assuntos
Carcinogênese/metabolismo , Transformação Celular Neoplásica/metabolismo , Ferroptose/fisiologia , Proteínas de Membrana/metabolismo , Pâncreas/metabolismo , Animais , Biomarcadores Tumorais , Carcinogênese/genética , Carcinoma Ductal Pancreático/metabolismo , Carcinoma Ductal Pancreático/patologia , Morte Celular/fisiologia , Transformação Celular Neoplásica/genética , Transformação Celular Neoplásica/patologia , DNA , Dieta , Modelos Animais de Doenças , Feminino , Ferroptose/efeitos dos fármacos , Humanos , Ferro/metabolismo , Macrófagos , Masculino , Proteínas de Membrana/genética , Camundongos , Camundongos Knockout , Pâncreas/patologia , Pancreatite/genética , Fosfolipídeo Hidroperóxido Glutationa Peroxidase/genética , Fosfolipídeo Hidroperóxido Glutationa Peroxidase/metabolismo , Proteínas Proto-Oncogênicas p21(ras)/metabolismo , Quinoxalinas/farmacologia , Compostos de Espiro/farmacologia , Microambiente Tumoral
10.
Zhonghua Yi Xue Za Zhi ; 100(48): 3853-3858, 2020 Dec 29.
Artigo em Chinês | MEDLINE | ID: mdl-33371630

RESUMO

Objective: To investigate the clinical effect of ipsilateral simultaneous pancreas and kidney transplantation (SPK). Methods: A total of 146 cases of SPK surgeries completed in the Second Affiliated Hospital of Guangzhou Medical University from September 2016 to June 2020 were selected to summarize the outcome, curative effect and complications of the operation. Results: The patients were followed up for 1 to 45 months. Good clinical results were obtained in 146 patients. Renal function indicators suggest that on the 7th day after operation, the serum creatinine returned to normal level [142.4 (108.6, 213.4)µmol/L]. The index of pancreatic function decreased to the normal level as expected. The level of blood amylase was 160.5(109.3, 249.8) U/L within 7 days after operation, and then decreased. The trend of urinary amylase was similar to that of blood amylase, which was 240(121.0, 370.0) U/L 7 days after operation, and glycosylated hemoglobin decreased to the normal level (5.8%±1.4%) 1 month after operation. The main medical complications were infection including pulmonary infection (26.03%, 38/146), urinary tract infection (26.03%,38/146), and abdominal infection (4.79%,7/146), acute rejection including renal graft rejection (5.8%,8/146), pancreas/duodenum rejection (18.49%,27/146), and renal graft combined pancreatic graft rejeciton (6.85%,10/146), as well as gastrointestinal bleeding (30.82%,45/146), of which 5 cases were severe bleeding (3.42%, 5/146). The main surgical complications were poor incision healing (10.27%, 15/146), serious surgical complications including arteriovenous thrombosis of the transplanted pancreas (2.05%, 3/146) and intestinal leakage (0.68%,1/146). The 1-year and 3-year patient, renal and pancreatic survival rates were both 92.5%, 91.5% and 89.5%, respectively, and despite the death, the 1-year, 3-year transplanted kidney survival rate was both 99.3%, and 95% for the the 1-year, 3-year pancreas survival rate. Conclusion: Strict preoperative evaluation of the function of large organs, reasonable surgical methods, perioperative anticoagulation, and prompt diagnosis of complications can achieve good clinical results for patients with SPK.


Assuntos
Diabetes Mellitus Tipo 1 , Nefropatias , Transplante de Rim , Transplante de Pâncreas , Creatinina , Rejeição de Enxerto , Sobrevivência de Enxerto , Humanos , Pâncreas
11.
Front Endocrinol (Lausanne) ; 11: 596898, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33281748

RESUMO

Increasing evidence demonstrated that the expression of Angiotensin I-Converting Enzyme type 2 (ACE2) is a necessary step for SARS-CoV-2 infection permissiveness. In light of the recent data highlighting an association between COVID-19 and diabetes, a detailed analysis aimed at evaluating ACE2 expression pattern distribution in human pancreas is still lacking. Here, we took advantage of INNODIA network EUnPOD biobank collection to thoroughly analyze ACE2, both at mRNA and protein level, in multiple human pancreatic tissues and using several methodologies. Using multiple reagents and antibodies, we showed that ACE2 is expressed in human pancreatic islets, where it is preferentially expressed in subsets of insulin producing ß-cells. ACE2 is also highly expressed in pancreas microvasculature pericytes and moderately expressed in rare scattered ductal cells. By using different ACE2 antibodies we showed that a recently described short-ACE2 isoform is also prevalently expressed in human ß-cells. Finally, using RT-qPCR, RNA-seq and High-Content imaging screening analysis, we demonstrated that pro-inflammatory cytokines, but not palmitate, increase ACE2 expression in the ß-cell line EndoC-ßH1 and in primary human pancreatic islets. Taken together, our data indicate a potential link between SARS-CoV-2 and diabetes through putative infection of pancreatic microvasculature and/or ductal cells and/or through direct ß-cell virus tropism.


Assuntos
/metabolismo , Células Secretoras de Insulina/metabolismo , Microvasos/metabolismo , Pâncreas/metabolismo , /isolamento & purificação , /metabolismo , Células Cultivadas , Citocinas/metabolismo , Humanos , Células Secretoras de Insulina/virologia , Microvasos/virologia , Pâncreas/virologia
12.
PLoS One ; 15(12): e0242445, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33301490

RESUMO

Acyl-CoA dehydrogenase 10 (Acad10)-deficient mice develop impaired glucose tolerance, peripheral insulin resistance, and abnormal weight gain. In addition, they exhibit biochemical features of deficiencies of fatty acid oxidation, such as accumulation of metabolites consistent with abnormal mitochondrial energy metabolism and fasting induced rhabdomyolysis. ACAD10 has significant expression in mouse brain, unlike other acyl-CoA dehydrogenases (ACADs) involved in fatty acid oxidation. The presence of ACAD10 in human tissues was determined using immunohistochemical staining. To characterize the effect of ACAD10 deficiency on the brain, micro-MRI and neurobehavioral evaluations were performed. Acad10-deficient mouse behavior was examined using open field testing and DigiGait analysis for changes in general activity as well as indices of gait, respectively. ACAD10 protein was shown to colocalize to mitochondria and peroxisomes in lung, muscle, kidney, and pancreas human tissue. Acad10-deficient mice demonstrated subtle behavioral abnormalities, which included reduced activity and increased time in the arena perimeter in the open field test. Mutant animals exhibited brake and propulsion metrics similar to those of control animals, which indicates normal balance, stability of gait, and the absence of significant motor impairment. The lack of evidence for motor impairment combined with avoidance of the center of an open field arena and reduced vertical and horizontal exploration are consistent with a phenotype characterized by elevated anxiety. These results implicate ACAD10 function in normal mouse behavior, which suggests a novel role for ACAD10 in brain metabolism.


Assuntos
Acil-CoA Desidrogenase/genética , Ansiedade/genética , Encéfalo/enzimologia , Metabolismo Energético/genética , Mitocôndrias/enzimologia , Acil-CoA Desidrogenase/deficiência , Acil-CoA Desidrogenase/metabolismo , Animais , Ansiedade/enzimologia , Ansiedade/fisiopatologia , Comportamento Animal , Encéfalo/diagnóstico por imagem , Carnitina/análogos & derivados , Carnitina/metabolismo , Marcha/fisiologia , Humanos , Rim/enzimologia , Fígado/enzimologia , Pulmão/enzimologia , Imagem por Ressonância Magnética , Aprendizagem em Labirinto , Camundongos , Camundongos Knockout , Músculo Esquelético/enzimologia , Pâncreas/enzimologia , Peroxissomos/enzimologia
13.
S D Med ; 73(9): 410-413, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33260280

RESUMO

An 18-year-old female presented to a tertiary care center after sustaining blunt abdominal trauma. Work up, including computer tomography (CT) revealed a hypo-attenuated collection in the pancreatic body with concern for ductal injury on magnetic resonance cholangiopancreatography (MRCP). These findings were consistent with posttraumatic intrapancreatic hematoma. An exploratory laparotomy with distal pancreatectomy and splenectomy were performed with concern for a grade 3 pancreatic injury. Pathology of the excised pancreas showed presence of a solid pseudopapillary tumor in the body of the pancreas which had been obscured by the hematoma on imaging.


Assuntos
Neoplasias Pancreáticas , Ferimentos não Penetrantes , Adolescente , Colangiografia , Feminino , Humanos , Pâncreas/lesões , Pancreatectomia , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/cirurgia , Esplenectomia , Ferimentos não Penetrantes/diagnóstico por imagem
14.
Acta Gastroenterol Belg ; 83(4): 593-597, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33321016

RESUMO

Background and study aim: To evaluate the variability in the enhancement of pancreas on computed tomography (CT) in patients with acute pancreatitis (AP) and isolated extrapancreatic necrosis (EPN) and to investigate whether it affects the extrapancreatic findings and patient outcomes. Patients and methods: This retrospective study comprised of consecutive patients with isolated EPN evaluated between April 2017 and April 2019. A radiologist measured the pancreatic attenuation values (PAV) of head, body, and tail on a contrast enhanced CT. Using a cut-off PAV of 100HU, patients were divided into two groups. The extrapancreatic CT findings and outcome parameters were compared between the two groups. Results: Thirty patients (mean age, 42.13 years, 17 males) with isolated EPN were evaluated. The mean PAV in the head, body, and tail was 83.13 HU (range, 59-161), 84.17 HU (range, 60-160), and 82.23 HU (range, 53-137). The overall mean PAV was 83.12 HU (range, 58-152). There were six patients with overall mean PAV≥100 HU. The group with PAV≥100 HU had a higher number of patients with infected necrosis (66.6% vs. 14.2%, P=0.018). PAV had a significant association with length of hospitalization (P=0.045). Conclusion: There is significant variability in the pancreatic enhancement on CT among patients with AP and isolated EPN. Patients with PAV≥100 HU had a significantly longer hospital stay. This, however, may be related to a greater number of patients with infected necrosis in this group.


Assuntos
Pancreatite , Doença Aguda , Adulto , Humanos , Masculino , Necrose/diagnóstico por imagem , Pâncreas/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
15.
Acta Gastroenterol Belg ; 83(4): 639-642, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33321022

RESUMO

Introduction: Bifurcation of the pancreatic duct is a very rare anomaly and clinical significance is not known. Literature on this topic is scarce. We present two similar case reports with bifurcation of the main pancreatic duct from the body to the tail of the pancreas. Both cases were symptomatic, one had acute pancreatitis and the other recurrent pancreatitis. In both cases the most ventral duct was aberrant as a consequence of pancreatitis. Discussion: We performed a literature study and found 22 relevant articles containing 26 case reports, of these cases, 12 were considered asymptomatic and were found incidentally, the other 14 cases were symptomatic with signs of acute, chronic or recurrent pancreatitis. To our knowledge this is the first article with a summary of previous published data on the subject. Conclusion: Bifurcation of the pancreatic duct seems to be a possible cause of pancreatitis, but a large group remains asymptomatic. Since diagnosis is often difficult, the incidence is probably underestimated. More attention to this anomaly is recommended. Further reports are needed to draw conclusion.


Assuntos
Ductos Pancreáticos , Pancreatite Crônica , Doença Aguda , Humanos , Pâncreas/diagnóstico por imagem
16.
Cell Metab ; 32(6): 1041-1051.e6, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33207244

RESUMO

Diabetes is associated with increased mortality from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Given literature suggesting a potential association between SARS-CoV-2 infection and diabetes induction, we examined pancreatic expression of angiotensin-converting enzyme 2 (ACE2), the key entry factor for SARS-CoV-2 infection. Specifically, we analyzed five public scRNA-seq pancreas datasets and performed fluorescence in situ hybridization, western blotting, and immunolocalization for ACE2 with extensive reagent validation on normal human pancreatic tissues across the lifespan, as well as those from coronavirus disease 2019 (COVID-19) cases. These in silico and ex vivo analyses demonstrated prominent expression of ACE2 in pancreatic ductal epithelium and microvasculature, but we found rare endocrine cell expression at the mRNA level. Pancreata from individuals with COVID-19 demonstrated multiple thrombotic lesions with SARS-CoV-2 nucleocapsid protein expression that was primarily limited to ducts. These results suggest SARS-CoV-2 infection of pancreatic endocrine cells, via ACE2, is an unlikely central pathogenic feature of COVID-19-related diabetes.


Assuntos
/genética , Pâncreas/metabolismo , Internalização do Vírus , /análise , /complicações , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/metabolismo , Expressão Gênica , Humanos , Pâncreas/irrigação sanguínea , Serina Endopeptidases/análise , Serina Endopeptidases/genética , Serina Endopeptidases/metabolismo , Doadores de Tecidos
17.
Cell Metab ; 32(6): 1028-1040.e4, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33207245

RESUMO

Isolated reports of new-onset diabetes in individuals with COVID-19 have led to the hypothesis that SARS-CoV-2 is directly cytotoxic to pancreatic islet ß cells. This would require binding and entry of SARS-CoV-2 into ß cells via co-expression of its canonical cell entry factors, angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2); however, their expression in human pancreas has not been clearly defined. We analyzed six transcriptional datasets of primary human islet cells and found that ACE2 and TMPRSS2 were not co-expressed in single ß cells. In pancreatic sections, ACE2 and TMPRSS2 protein was not detected in ß cells from donors with and without diabetes. Instead, ACE2 protein was expressed in islet and exocrine tissue microvasculature and in a subset of pancreatic ducts, whereas TMPRSS2 protein was restricted to ductal cells. These findings reduce the likelihood that SARS-CoV-2 directly infects ß cells in vivo through ACE2 and TMPRSS2.


Assuntos
/metabolismo , Diabetes Mellitus/metabolismo , Serina Endopeptidases/metabolismo , Internalização do Vírus , /análise , Animais , /genética , Células Cultivadas , Complicações do Diabetes/genética , Complicações do Diabetes/metabolismo , Diabetes Mellitus/genética , Expressão Gênica , Humanos , Células Secretoras de Insulina/metabolismo , Camundongos , Microvasos/metabolismo , Pâncreas/metabolismo , RNA Mensageiro/análise , RNA Mensageiro/genética , Serina Endopeptidases/análise , Serina Endopeptidases/genética
20.
J Assoc Physicians India ; 68(12): 58-60, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33247644

RESUMO

Background and Aim: Coronavirus disease 2019 (COVID 2019) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may cause multisystem dysfunction. We studied pancreatic injury (serum amylase and serum lipase levels) in COVID-19 patients. Methods: A retrospective study involving 42 COVID-19 patients (diagnosed by real-time PCR) admitted to a tertiary care hospital was conducted. Serum amylase and serum lipase levels were analysed in relation to severity of COVID-19 and mortality. Results: Mean age of patients was 50 ± 16 years, with male to female ratio of 3.7:1. Serum amylase was elevated in 14 patients (33%). Serum lipase was elevated in 7 out of 29 patients (24.1%). Mortality was seen in 18 patients (42.8%). Serum amylase or lipase did not correlate with severity of COVID-19 or its mortality. However, both patients who had high lipase (>3times) died. Conclusion: The prevalence of hyperamylasemia in patients of COVID-19 was 33%, while that of elevated lipase was 24.1%. Pancreatic injury failed to show any statistically significant relation to severity or outcome of COVID-19.


Assuntos
Infecções por Coronavirus , Pâncreas , Pancreatopatias , Pandemias , Pneumonia Viral , Adulto , Idoso , Betacoronavirus , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatopatias/virologia , Estudos Retrospectivos
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