Nathan Jaimie D, Romac Joelle, Peng Ruth Y, Peyton Michael, Macdonald Raymond J, Liddle Rodger A
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Gastroenterology. 2005 Mar;128(3):717-27. doi: 10.1053/j.gastro.2004.11.052.
BACKGROUND & AIMS: Endogenous trypsin inhibitors are believed to inhibit protease activity if trypsin becomes inadvertently activated within the acinar cell. However, this action remains unproven, and the role of endogenous pancreatic trypsin inhibitors in acute pancreatitis is unknown. In this study, we tested whether increased levels of pancreatic secretory trypsin inhibitor-I (PSTI-I) in mice could prevent secretagogue-induced pancreatitis.
Rat PSTI-I expression was targeted to pancreatic acinar cells in transgenic mice by creating a minigene driven by the rat elastase I enhancer/promoter. Secretagogue-induced pancreatitis was achieved by 12 hourly intraperitoneal injections of caerulein. The severity of pancreatitis was assessed by measurements of serum amylase, histologic grading, and pancreas wet weight-to-body weight ratio. Trypsinogen activation and trypsin activity were measured in pancreatic extracts.
Targeted expression of PSTI-I to the pancreas increased endogenous trypsin inhibitor capacity by 190% (P <.01) in transgenic vs. nontransgenic mice. Caerulein administration to nontransgenic mice produced histologic evidence of acute pancreatitis, and significantly elevated serum amylase and pancreas weight ratio. In caerulein-treated transgenic mice, the histologic severity of pancreatitis was significantly reduced. There was no difference in trypsinogen activation peptide levels between caerulein-treated transgenic and nontransgenic mice. However, trypsin activity was significantly lower in transgenic mice receiving caerulein compared with nontransgenic mice.
These data demonstrate that the severity of secretagogue-induced pancreatitis is significantly ameliorated in mice with higher pancreatic levels of trypsin inhibitor. We propose that PSTI-I prevents pancreatitis by inhibiting the activity of trypsin, rather than by reducing trypsinogen activation.
内源性胰蛋白酶抑制剂被认为可在腺泡细胞内胰蛋白酶意外激活时抑制蛋白酶活性。然而,这一作用尚未得到证实,内源性胰腺胰蛋白酶抑制剂在急性胰腺炎中的作用也尚不明确。在本研究中,我们检测了小鼠胰腺分泌性胰蛋白酶抑制剂-I(PSTI-I)水平升高是否能预防促分泌素诱导的胰腺炎。
通过构建由大鼠弹性蛋白酶I增强子/启动子驱动的小基因,使大鼠PSTI-I表达靶向转基因小鼠的胰腺腺泡细胞。通过每12小时腹腔注射蛙皮素诱导促分泌素诱导的胰腺炎。通过测定血清淀粉酶、组织学分级以及胰腺湿重与体重之比来评估胰腺炎的严重程度。在胰腺提取物中测量胰蛋白酶原激活和胰蛋白酶活性。
与非转基因小鼠相比,PSTI-I在胰腺中的靶向表达使转基因小鼠的内源性胰蛋白酶抑制能力提高了190%(P<.01)。给非转基因小鼠注射蛙皮素产生了急性胰腺炎的组织学证据,并显著提高了血清淀粉酶和胰腺重量比。在接受蛙皮素治疗的转基因小鼠中,胰腺炎的组织学严重程度显著降低。接受蛙皮素治疗的转基因小鼠和非转基因小鼠之间的胰蛋白酶原激活肽水平没有差异。然而,与非转基因小鼠相比,接受蛙皮素治疗的转基因小鼠的胰蛋白酶活性显著降低。
这些数据表明,胰蛋白酶抑制剂水平较高的小鼠中,促分泌素诱导的胰腺炎严重程度得到显著改善。我们认为PSTI-I通过抑制胰蛋白酶的活性而非减少胰蛋白酶原激活来预防胰腺炎。