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1.
Acta Gastroenterol Belg ; 84(3): 437-442, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34599568

RESUMO

Background and study aims: Factors such as age, obesity, diabetes mellitus and hyperlipidemia that cause adverse prognosis in acute pancreatitis also cause an increase in carotid intima-media thickness. In this study, we aimed to investigate the usability of the measurement of carotid intima-media thickness, which is an easy to apply, cost-effective means of measurement applied to the patients, in predicting AP prognosis, apart from the criteria currently utilized to predict AP prognosis. Patients and methods: 101 patients diagnosed with acute pancreatitis were prospectively enrolled into the study. Right and left common carotid artery intima-media thickness, right and left internal carotid artery intima-media thickness were measured with ultrasonographic images performed within the first 24 hours of hospitalization. local or systemic complications and organ failure development were monitored in the follow-up of the patients. Results: After the ROC analysis was performed and the threshold value was determined. The patients with main and internal carotid artery intima-media thickness above 0.775 mm were seen to have a more severe AP (p = 0.000). Local and systemic complications and organ failure were also more common in these patients. Conclusions: Measurement of carotid intima-media thickness is a non-invasive method that can be used to predict the prognosis in patients with acute pancreatitis at presentation.


Assuntos
Espessura Intima-Media Carotídea , Pancreatite , Doença Aguda , Artérias Carótidas , Humanos , Pancreatite/diagnóstico por imagem , Prognóstico
2.
Acta Gastroenterol Belg ; 84(3): 451-455, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34599570

RESUMO

Background and aims: Endoscopic ultrasound fine-needle aspiration/biopsy (EUS-FNA/FNB) is highly accurate, but discrepancies between cytological and surgical diagnoses are still observed. We aimed to determine its accuracy and monitor quality indicators in our facilities. Patients and methods: We performed a retrospective review of all cases of pancreatic solid lesions evaluated by EUS-FNA/FNB, between July 2015 and June 2018, in two centers. Cytological and surgical findings were categorized into five groups: benign, malignant, suspect of malignancy, undetermined and insufficient for diagnosis. Final diagnosis was based on surgical diagnosis and, in patients who did not undergo surgery, on clinical outcome after 6 months follow-up. Results: Altogether, 142 patients were included. FNA was the preferred tissue acquisition method (88%), with a predilection for the FNA 22G needle (57%). Cytology was insufficient for diagnosis in 2 cases, therefore a full diagnostic sample was available in 98.6% of the patients (>90%, ESGE target). Fifty-five (38.7%) patients underwent surgery. In term of cancer diagnosis, comparison with final surgical pathology (n=55) revealed 89% true positives, 5.5% true negatives, 3.6% false positives and 1.8% false negatives. When combining surgical diagnosis and clinical outcomes together, EUS-guided sampling sensitivity was 97.4% (92.5-99.5), specificity was 92.3% (74.9-99.1), positive predictive value was 98.2% (93.6- 99.5), negative predictive value was 88.9% (72.3-96.1) and accuracy was 96.4% (91.9-98.8). Post-procedural acute pancreatitis was reported in 2 patients (1.4%). Conclusions: These results reveal a performance for diagnostic tissue sampling well above the ESGE proposed target standard. Also, the uncommon high specificity illustrates the determining role of the pathologist's final interpretation and diagnosis.


Assuntos
Neoplasias Pancreáticas , Pancreatite , Doença Aguda , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Endoscopia , Humanos , Neoplasias Pancreáticas/diagnóstico por imagem , Indicadores de Qualidade em Assistência à Saúde , Estudos Retrospectivos
3.
Ann Palliat Med ; 10(9): 9792-9799, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34628905

RESUMO

BACKGROUND: To retrospectively analyze the effects of routine treatment and blood purification combined with antibiotics on the extravascular lung water index (EVLWI), inflammatory factors, and treatment outcomes in patients with severe acute pancreatitis (SAP) complicated with acute respiratory distress syndrome (ARDS). METHODS: A total of 131 SAP patients admitted to the intensive care unit of Suzhou Ninth Hospital Affiliated to Soochow University from January 2019 to December 2020 were retrospectively enrolled in this study. Patients were divided into two groups according to the treatment methods. In addition to conventional treatment, 60 patients in group A received continuous blood purification (CBP) treatment and 71 patients in group B did not. The EVLWI, inflammatory factors, remission time of clinical symptoms, curative effect, and patient outcomes were recorded at admission and after 1, 3, 5, and 7 days of treatment. RESULTS: There was a statistically significant difference in the clinical symptom relief time and the clinical efficacy between the two groups of patients (P<0.05). The mortality rate of patients in group A was 3.33%, which was significantly lower than the 14% mortality rate observed in patients in group B (P<0.05). The EVLWI, as well as the C-reactive protein (CRP), interleukin (IL)-6, IL-8, and tumor necrosis factor (TNF)-α levels were significantly lower in group A patients compared to group B patients on day 1, 3, and 7 post-treatment (P<0.05). There was also a significant difference in APACHE II scores between the two groups (P<0.05). The incidence of adverse reactions in group A was 6.7%, which was significantly lower than the 22.5% incidence observed in group B (P<0.05). CONCLUSIONS: Continuous blood purification combined with antibacterial drugs is safe and has a significant effect on the treatment of SAP patient complicated with ARDS, including effectively relieving clinical symptoms and signs, reducing the level of inflammatory factors, and promoting early disease outcomes.


Assuntos
Pancreatite , Síndrome do Desconforto Respiratório , Doença Aguda , Antibacterianos/uso terapêutico , Água Extravascular Pulmonar , Humanos , Pancreatite/tratamento farmacológico , Prognóstico , Síndrome do Desconforto Respiratório/tratamento farmacológico , Estudos Retrospectivos
4.
World J Gastroenterol ; 27(35): 5796-5802, 2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34629803

RESUMO

Drug-induced pancreatitis is a gastrointestinal adverse effect concerning about 2% of drugs. The majority of cases are mild to moderate but severe episodes can also occur, leading to hospitalization or even death. Unfortunately, the mechanisms of this adverse reaction are still not clear, hindering its prevention, and the majority of data available of this potentially life-threatening adverse effect are limited to case reports leading to a probable underestimation of this event. In particular, in this editorial, special attention is given to thiopurine-induced pancreatitis (TIP), an idiosyncratic adverse reaction affecting around 5% of inflammatory bowel disease (IBD) patients taking thiopurines as immunosuppressants, with a higher incidence in the pediatric population. Validated biomarkers are not available to assist clinicians in the prevention of TIP, also because of the inaccessibility of the pancreatic tissue, which limits the possibility to perform dedicated cellular and molecular studies. In this regard, induced pluripotent stem cells (iPSCs) and the exocrine pancreatic differentiated counterpart could be a great tool to investigate the cellular and molecular mechanisms underlying the development of this undesirable event. This particular type of stem cells is obtained by reprogramming adult cells, including fibroblasts and leukocytes, with a set of transcription factors known as the Yamanaka's factors. Maintaining unaltered the donors' genetic heritage, iPSCs represent an innovative model to study the mechanisms of adverse drug reactions in individual patients' tissues not easily obtainable from human probands. Indeed, iPSCs can differentiate under adequate stimuli into almost any somatic lineage, opening a new world of opportunities for researchers. Several works are already available in the literature studying liver, central nervous system and cardiac cells derived from iPSCs and adverse drug effects. However, to our knowledge no studies have been performed on exocrine pancreas differentiated from iPSCs and drug-induced pancreatitis, so far. Hence, in this editorial we focus specifically on the description of the study of the mechanisms of TIP by using IBD patient-specific iPSCs and exocrine pancreatic differentiated cells as innovative in vitro models.


Assuntos
Células-Tronco Pluripotentes Induzidas , Pancreatite , Preparações Farmacêuticas , Diferenciação Celular , Criança , Humanos , Pâncreas , Pancreatite/induzido quimicamente
7.
MMW Fortschr Med ; 163(18): 66-69, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34652672

Assuntos
Lipase , Pancreatite , Humanos
8.
BMC Surg ; 21(1): 356, 2021 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-34600501

RESUMO

BACKGROUND: Acute pancreatitis after liver resection is a rare but serious complication, and few cases have been described in the literature. Extended lymphadenectomy, and long ischemia due to the Pringle maneuver could be responsible of post-liver resection acute pancreatitis, but the exact causes of AP after hepatectomy remain unclear. CASES PRESENTATION: We report here three cases of AP after hepatectomy and we strongly hypothesize that this is due to the bile leakage white test. 502 hepatectomy were performed at our center and 3 patients (0.6%) experienced acute pancreatitis after LR and all of these three patients underwent the white test at the end of the liver resection. None underwent additionally lymphadenectomy to the liver resection. All patient had a white-test during the liver surgery. We identified distal implantation of the cystic duct in these three patients as a potential cause for acute pancreatitis. CONCLUSION: The white test is useful for detection of bile leakage after liver resection, but we do not recommend a systematic use after LR, because severe acute pancreatitis can be lethal for the patient, especially in case of distal cystic implantation which may facilitate reflux in the main pancreatic duct.


Assuntos
Hepatectomia , Pancreatite , Doença Aguda , Bile , Hepatectomia/efeitos adversos , Humanos , Fígado , Pancreatite/diagnóstico , Pancreatite/etiologia
9.
Mymensingh Med J ; 30(4): 1073-1078, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605479

RESUMO

Dengue is endemic in more than a hundred countries throughout the tropics. The classic presentation of dengue fever has expanded its horizon by involving different organ systems, and these system-specific presentations pose a diagnostic dilemma. The objective of this prospective observational study was to evaluate the sociodemographic, and clinical profile of expanded dengue syndrome (EDS) patients admitted to a tertiary hospital in Dhaka, Bangladesh. Data were collected from all admitted patients from April 2019 to September 2019 and diagnosed with dengue. The patients with dengue having EDS were followed up till discharge. Of 4200 dengue cases admitted during this period, 108 patients (2.57%) were diagnosed with EDS. Among the EDS cases, 94% were from Dhaka city, and 6% were outside Dhaka city; 66% of the patients were male. Gastrointestinal (GI) manifestations were the most common (87%) type of EDS, and among the GI presentations, acute acalculous cholecystitis (38.3%), acute pancreatitis (30.85%), acute hepatitis (21.27%) were the most frequent. Among the EDS cases, 5.55% had a central nervous system (CNS), 4.6% cardiovascular (CVS), and 1.88% had renal complications; 0.93% presented with myositis. The majority (90.74%) of the patients recovered with conservative management, 10 (9.26%) died. This study shows that expanded dengue syndrome (EDS) is not uncommon in Bangladesh's dengue viral infection. A high degree of clinical suspicion is the key to early diagnosis and treatment.


Assuntos
Dengue , Pancreatite , Doença Aguda , Bangladesh/epidemiologia , Dengue/diagnóstico , Dengue/epidemiologia , Dengue/terapia , Humanos , Laboratórios , Masculino , Estudos Prospectivos , Centros de Atenção Terciária
10.
Medicine (Baltimore) ; 100(35): e27182, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477177

RESUMO

ABSTRACT: In this single-center retrospective study, we intended to evaluate the frequencies and characteristics of computed tomography findings of pancreatobiliary inflammation (PBI) in patients treated with lenvatinib and the relationship of these findings with treatment-planning changes.We included 78 patients (mean ±â€Šstandard deviation, 69.8 ±â€Š9.4 years, range: 39-84 years, 62 men) with hepatocellular carcinoma (n = 62) or thyroid carcinoma (n = 16) who received lenvatinib (June 2016-September 2020). Two radiologists interpreted the posttreatment computed tomography images and assessed the radiological findings of PBI (symptomatic pancreatitis, cholecystitis, or cholangitis). The PBI effect on treatment was statistically evaluated.PBI (pancreatitis, n = 1; cholecystitis, n = 7; and cholangitis, n = 2) was diagnosed in 11.5% (9/78) of the patients at a median of 35 days after treatment initiation; 6 of 9 patients discontinued treatment because of PBI. Three cases of cholecystitis and 1 of cholangitis were accompanied by gallstones, while the other 5 were acalculous. The treatment duration was significantly shorter in patients with PBI than in those without (median: 44 days vs. 201 days, P = .02). Overall, 9 of 69 patients without PBI showed asymptomatic gallbladder subserosal edema.Lenvatinib-induced PBI developed in 11.5% of patients, leading to a significantly shorter treatment duration. Approximately 55.6% of the PBI cases were acalculous. The recognition of this phenomenon would aid physicians during treatment planning in the future.


Assuntos
Antineoplásicos/efeitos adversos , Doenças Biliares/induzido quimicamente , Pancreatite/induzido quimicamente , Compostos de Fenilureia/efeitos adversos , Quinolinas/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Biliares/diagnóstico por imagem , Doenças Biliares/epidemiologia , Feminino , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pancreatite/diagnóstico por imagem , Pancreatite/epidemiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
11.
Wiad Lek ; 74(8): 1794-1799, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34537722

RESUMO

OBJECTIVE: The aim: Improve the treatment outcomes of patients with fl uid collections following acute pancreatitis using an ultrasound-guided puncture and catheter drainage methods. PATIENTS AND METHODS: Materials and methods: 67 patients with acute pancreatitis complicated by fl uid collections were divided into two groups. The fi rst group (comparison group) consisted of 32 patients who underwent percutaneous ultrasound-guided puncture and catheter drainage interventions in addition to conservative therapy. The second group (control group) consisted of 35 patients receiving conservative therapy. The age of patients was from 18 to 77 years. In the comparison group among 32 patients there were 19 women and 13 men, the average age consisted 48.2 ± 2.2 years. In the control group among 35 patients there were 21 women and 14 men, the average age of patients consisted 47.1 ± 2.3 years. RESULTS: Results: The mortality rate in the comparison group was 2 (6.2%) cases, in the control group - 4 (11.4%) cases (p <0.05). Infection of fl uid collections developed in 2 (6.2%) patients of the comparison group and in 5 (14.3%) patients of the control group. The average length of stay in the hospital of patients in the comparison group was 24.13 ± 2.17 days, in the control group 28.11 ± 1.05 days (p <0.05). Also in the comparison group there was a faster normalization of clinical and laboratory indicators (level of leukocytes, serum amylase, C-reactive protein) (p <0,05). CONCLUSION: Conclusions: the use of percutaneous ultrasound-guided puncture and catheter drainage methods has reduced mortality and improved treatment outcomes in patients with acute pancreatitis complicated by fluid collections.


Assuntos
Pancreatite , Doença Aguda , Adolescente , Adulto , Idoso , Cateteres , Drenagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite/complicações , Pancreatite/terapia , Punções , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia de Intervenção , Adulto Jovem
12.
World J Gastroenterol ; 27(30): 5019-5036, 2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34497432

RESUMO

The gut microbiome is a complex microbial community, recognized for its potential role in physiology, health, and disease. The available evidence supports the role of gut dysbiosis in pancreatic disorders, including acute pancreatitis (AP). In AP, the presence of gut barrier damage resulting in increased mucosal permeability may lead to translocation of intestinal bacteria, necrosis of pancreatic and peripancreatic tissue, and infection, often accompanied by multiple organ dysfunction syndrome. Preserving gut microbial homeostasis may reduce the systemic effects of AP. A growing body of evidence suggests the possible involvement of the gut microbiome in various pancreatic diseases, including AP. This review discusses the possible role of the gut microbiome in AP. It highlights AP treatment and supplementation with prebiotics, synbiotics, and probiotics to maintain gastrointestinal microbial balance and effectively reduce hospitalization, morbidity and mortality in an early phase. It also addresses novel therapeutic areas in the gut microbiome, personalized treatment, and provides a roadmap of human microbial contributions to AP that have potential clinical benefit.


Assuntos
Microbioma Gastrointestinal , Pancreatite , Probióticos , Doença Aguda , Disbiose , Humanos , Pancreatite/terapia , Prebióticos , Probióticos/uso terapêutico
13.
J Med Case Rep ; 15(1): 461, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34503570

RESUMO

INTRODUCTION: We report a case of Severe acute respiratory syndrome coronavirus-2 infection with acute pancreatitis as the only presenting symptom. To the best of our knowledge, there are few case reports of the same presentation. CASE PRESENTATION: An otherwise healthy 44-year-old white male from Egypt presented to the hospital with severe epigastric pain and over ten attacks of nonprojectile vomiting (first, gastric content, then bilious). Acute pancreatitis was suspected and confirmed by serum amylase, serum lipase, and computed tomography scan that showed mild diffuse enlargement of the pancreas. The patient did not have any risk factor for acute pancreatitis, and extensive investigations did not reveal a clear etiology. Given a potential occupational exposure, a nasopharyngeal swab for polymerase chain reaction testing for severe acute respiratory syndrome coronavirus 2 was done, which was positive despite the absence of the typical symptoms of severe acute respiratory syndrome coronavirus 2 such as fever and respiratory symptoms. The patient was managed conservatively. For pancreatitis, he was kept nil per os for 2 days and received intravenous lactated Ringer's (10 ml per kg per hour), nalbuphine, alpha chymotrypsin, omeprazole, and cyclizine lactate. For severe acute respiratory syndrome coronavirus 2, he received a 5-day course of intravenous azithromycin (500 mg per day). He improved quickly and was discharged by the fifth day. We know that abdominal pain is not a rare symptom of severe acute respiratory syndrome coronavirus 2, and we also know that elevated levels of serum amylase and lipase were reported in severe acute respiratory syndrome coronavirus-2 patients, especially those with severe symptoms. However, the association between severe acute respiratory syndrome coronavirus-2 infection and idiopathic acute pancreatitis is rare and has been reported only a few times. CONCLUSION: We believe further studies should be conducted to determine the extent of pancreatic involvement in severe acute respiratory syndrome coronavirus-2 patients and the possible causality between severe acute respiratory syndrome coronavirus 2 and acute pancreatitis. We reviewed the literature regarding the association between severe acute respiratory syndrome coronavirus 2 and acute pancreatitis patients. Published data suggest that severe acute respiratory syndrome coronavirus 2 possibly could be a risk factor for acute pancreatitis.


Assuntos
COVID-19 , Pancreatite , Doença Aguda , Adulto , Humanos , Masculino , Pancreatite/diagnóstico , Pancreatite/etiologia , SARS-CoV-2 , Tomografia Computadorizada por Raios X
14.
Science ; 373(6561): eabj0486, 2021 09 17.
Artigo em Inglês | MEDLINE | ID: mdl-34529467
15.
BMC Infect Dis ; 21(1): 977, 2021 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-34544384

RESUMO

BACKGROUND: Multidrug-resistant (MDR) Klebsiella pneumoniae infections, from pancreatic infections to bloodstream infections, influence the mortality of patients with acute pancreatitis (AP) on the condition of limited antibiotic choices. The aim of this study was to investigate the predictor of mortality among AP patients complicated with MDR-K. pneumoniae infections. METHODS: Seventy-one AP patients who occurred MDR-K. pneumoniae infections from August 1st, 2016 to August 1st, 2020 were enrolled. MDR-K. pneumoniae was defined as the K. pneumoniae strain non-susceptible to at least one agent in three or more antimicrobial categories. MDR-K. pneumoniae isolates were confirmed by Vitek-2 system. Antibiotic susceptibility test was carried out using a micro broth dilution method. Clinical characteristics and drug-resistance rates were retrospectively reviewed, and the predictors of mortality were evaluated by univariate and multivariate analyses. RESULTS: The mortality rate of AP patients complicated with MDR-K. pneumoniae infections reached 46.5% (33 of 71), and pancreas (n = 53) was the most common site of MDR-K pneumoniae strains. The drug resistance rates of MDR-K. pneumoniae were high to 11 of 12 common antibiotics (more than 50.0%) except of tigecycline (23.9%). The predictor independently associated with mortality was septic shock (hazard ratio 2.959, 95% confidence intervals 1.396 - 6.272, P = 0.005). CONCLUSIONS: More attention should be paid for pancreatic MDR-K. pneumoniae infections among AP patients The predictor for mortality of AP patients complicated with MDR-K. pneumoniae infection is septic shock. Therefore, further clinical investigations should focus on areas against septic shock.


Assuntos
Infecções por Klebsiella , Pancreatite , Doença Aguda , Farmacorresistência Bacteriana Múltipla , Humanos , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae , Pancreatite/complicações , Pancreatite/tratamento farmacológico , Estudos Retrospectivos
16.
Internist (Berl) ; 62(10): 1044-1054, 2021 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-34524469

RESUMO

Abdominal imaging is an important component of the diagnostics of acute pancreatitis. In addition to the clinical features and the laboratory constellation, it serves to establish the diagnosis or the exclusion of other diseases and also the identification and assessment of the course of local complications and vascular changes that can arise during the course of acute pancreatitis. Due to the numerous imaging examination methods that are available, their combination options and the different examination times, there are diverse application options that have to be taken into account, such as the severity and duration of the disease, concomitant diseases and complications of acute pancreatitis. A rational use of imaging is an important prerequisite for high quality and at the same time cost-effective patient care. This review summarizes the current importance of imaging in acute pancreatitis, with particular reference to the updated S3 guidelines on acute pancreatitis.


Assuntos
Pancreatite , Doença Aguda , Diagnóstico por Imagem , Testes Diagnósticos de Rotina , Humanos , Imageamento por Ressonância Magnética , Pancreatite/diagnóstico por imagem
17.
Artigo em Inglês | MEDLINE | ID: mdl-34586307

RESUMO

Acute pancreatitis (AP) is an inflammatory disease associated with abdominal pain and elevated serum pancreatic enzymes. The most common etiologies are gallstones and alcoholism. Drug-induced AP is quite rare, lacks a solid understanding and has been occasionally reported. The diagnosis requires a great suspicion and a careful exclusion of other causes. We present a case of a 37-year-old man, previously diagnosed with leprosy that developed acute pancreatitis after starting the multibacillary polychemotherapy (PCT/MB). After a month of treatment and the discontinuation of the PCT/MB, the therapy was restarted and a new episode of AP occurred. Three months after this last episode, the PCT/MB was reintroduced, changing one of the medications and the patient had no recurrence of AP or other reactions. Therefore, it is important to take into account that there is a risk of acute pancreatitis in patients on multidrug therapy (MDT) for leprosy.


Assuntos
Hanseníase Multibacilar , Hanseníase , Pancreatite , Doença Aguda , Adulto , Quimioterapia Combinada , Humanos , Hansenostáticos/efeitos adversos , Hanseníase/complicações , Hanseníase/tratamento farmacológico , Masculino , Pancreatite/induzido quimicamente
18.
Vaccine ; 39(40): 5780-5786, 2021 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-34474934

RESUMO

Elevated triglycerides (TGs) are an important risk factor for the development of coronary heart disease (CHD) and in acute pancreatitis. Angiopoietin-like proteins 3 (ANGPTL3) and 4 (ANGPTL4) are critical regulators of TG metabolism that function by inhibiting the activity of lipoprotein lipase (LPL), which is responsible for hydrolyzing triglycerides in lipoproteins into free fatty acids. Interestingly, individuals with loss-of-function mutations in ANGPTL3 and ANGPTL4 have low plasma TG levels, have a reduced risk of CHD, and are otherwise healthy. Consequently, interventions targeting ANGPTL3 and ANGPTL4 have emerged as promising new approaches for reducing elevated TGs. Here, we developed virus-like particle (VLP) based vaccines that target the LPL binding domains of ANGPTL3 and ANGPTL4. ANGPTL3 VLPs and ANGPTL4 VLPs are highly immunogenic in mice and vaccination with ANGPTL3 VLPs, but not ANGPTL4 VLPs, was associated with reduced steady state levels of TGs. Immunization with ANGPTL3 VLPs rapidly cleared circulating TG levels following an oil gavage challenge and enhanced plasma LPL activity. These data indicate that targeting ANGPTL3 by active vaccination is a potential alternative to other ANGPTL3-inhibiting therapies.


Assuntos
Pancreatite , Vacinas de Partículas Semelhantes a Vírus , Doença Aguda , Proteína 4 Semelhante a Angiopoietina , Proteínas Semelhantes a Angiopoietina , Animais , Camundongos , Triglicerídeos
19.
Nutrients ; 13(9)2021 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-34579147

RESUMO

Acute pancreatitis (AP) is an inflammatory disease that causes severe tissue damage. Ghee butter from bovine colostrum (GBBC) is a clarified butter produced by heating milk fat to 40 °C and separating the precipitating protein. As colostrum mainly contains fatty acids (FAs), immunoglobulins, maternal immune cells, and cytokines, we hypothesized that it may exert anti-inflammatory effects. We investigated the effects of GBBC on experimental AP in mice. Two intraperitoneal (ip) injections of L-arginine (8%) were given 1 h apart to generate the AP murine model. After 12 h from the first L-arginine injection, mice were divided into the following experimental groups: AP mice treated with GBBC (oral gavage (po) every 12 h) and non-treated AP mice (po vehicle every 12 h). Control animals received vehicle only. At 72 h, mice were euthanized. Histopathological examination along with myeloperoxidase (MPO) and amylase/lipase activity assays were performed. In a separate set of experiments, FFAR1 and FFAR4 antagonists were used to verify the involvement of respective receptors. Administration of GBBC decreased MPO activity in the pancreas and lungs along with the microscopical severity of AP in mice. Moreover, treatment with GBBC normalized pancreatic enzyme activity. FFAR1 and FFAR4 antagonists tended to reverse the anti-inflammatory effect of GBBC in mouse AP. Our results suggest that GBBC displays anti-inflammatory effects in the mouse model of AP, with the putative involvement of FFARs. This is the first study to show the anti-inflammatory potential of a nutritional supplement derived from GBBC.


Assuntos
Anti-Inflamatórios/farmacologia , Colostro/química , Ácidos Graxos não Esterificados/metabolismo , Ghee/análise , Pancreatite/tratamento farmacológico , Amilases/metabolismo , Animais , Anti-Inflamatórios/química , Arginina/efeitos adversos , Bovinos , Citocinas/metabolismo , Modelos Animais de Doenças , Feminino , Inflamação/metabolismo , Lipase/metabolismo , Pulmão/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pâncreas/efeitos dos fármacos , Pancreatite/metabolismo , Peroxidase/metabolismo , Gravidez , Receptores Acoplados a Proteínas G/metabolismo
20.
Arch Argent Pediatr ; 119(5): e554-e558, 2021 10.
Artigo em Espanhol | MEDLINE | ID: mdl-34569762

RESUMO

In April 2020, UK studies informed a condition in children similar to incomplete Kawasaki disease or toxic shock syndrome. From that time onwards, papers on children suffering from similar conditions have been published in different parts of the world. Today the disease is named multisystem inflammatory syndrome in children (MIS-C) associated with Covid-19. Acute pancreatitis was reported mainly in adult patients with acute SARS-COV-2 infection developing direct cytopathic effect or immune-mediated and systemic inflammatory indirect cellular responses. However, there are only a few studies, which describe the acute pancreatitis case during MIS-C period. The present article describes the clinical presentation, therapy and evolution of a 9 years-old female patient developing an acute pancreatitis case suffering from MIS-C.


Assuntos
COVID-19 , Pancreatite , Pediatria , Doença Aguda , COVID-19/complicações , Criança , Feminino , Humanos , Pancreatite/complicações , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica
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