Neuschwander-Tetri B A, Burton F R, Presti M E, Britton R S, Janney C G, Garvin P R, Brunt E M, Galvin N J, Poulos J E
Department of Internal Medicine, Saint Louis University, Missouri, USA.
Dig Dis Sci. 2000 Apr;45(4):665-74. doi: 10.1023/a:1005423122127.
The role of repetitive acute injury in the pathogenesis of chronic pancreatitis remains unknown. To determine if repetitive injury induced by pancreatic hyperstimulation would reproduce the characteristic features of human chronic pancreatitis, acute reversible pancreatic injury was induced in mice by twice weekly cerulein treatment, 50 microg/kg/hr x 6 hr, for 10 weeks. Procollagen alpha1(I) mRNA was markedly increased by week 2. Sirius red staining of interstitial collagen demonstrated progressive accumulation of extracellular matrix surrounding acinar units and in interlobular spaces. Atrophy, transdifferentiation of acinar units to ductlike tubular complexes, and dilatation of intraacinar lumina also developed. Electron microscopy demonstrated the presence of stromal cells in areas of fibrosis with morphologic characteristics of pancreatic stellate cells. These findings demonstrate that, in a murine model, repetitive acute injury to the pancreas by hyperstimulation can reproduce the major morphological characteristics of human chronic pancreatitis.
反复急性损伤在慢性胰腺炎发病机制中的作用尚不清楚。为了确定胰腺过度刺激诱导的反复损伤是否会重现人类慢性胰腺炎的特征,通过每周两次用蛙皮素治疗(50μg/kg/小时×6小时),持续10周,在小鼠中诱导急性可逆性胰腺损伤。到第2周时,前胶原α1(I)mRNA显著增加。间质胶原的天狼星红染色显示腺泡单位周围和小叶间空间的细胞外基质逐渐积累。腺泡单位萎缩、向导管样管状复合体的转分化以及腺泡内管腔扩张也会出现。电子显微镜显示纤维化区域存在具有胰腺星状细胞形态特征的基质细胞。这些发现表明,在小鼠模型中,胰腺过度刺激引起的反复急性损伤可重现人类慢性胰腺炎的主要形态学特征。