Löhr M, Fischer B, Weber H, Emmrich J, Nizze H, Liebe S, Klöppel G
Department of Medicine, University of Rostock, Germany.
Digestion. 1999 Jan-Feb;60(1):48-55. doi: 10.1159/000007588.
Development of fibrosis characterizes chronic pancreatitis. As it results from deposition of extracellular matrix (ECM) proteins such as hyaluronan (HA) or laminin, the release of these ECM components into blood or pancreatic secretion may be enhanced during the course of chronic pancreatitis.
PATIENTS, MATERIAL AND METHODS: Using immunoassays for HA and laminin, the concentration for these ECM components was measured in pancreatic juice and serum samples from 20 patients with and 20 patients without chronic pancreatitis. Pancreatic calculi of varying size and weight obtained from 13 patients with chronic pancreatitis were also examined for the content of ECM components. Tissue samples from normal pancreas and those showing chronic pancreatitis were investigated immunocytochemically with an antibody to HA synthetase (HAS).
After stimulation with secretin high levels of ECM components were found in the initial washout period in chronic pancreatitis patients as well as in controls. HA levels, however, were seen seven times higher in patients with chronic pancreatitis (mean +/- SEM; 734 +/- 301 vs. 95 +/- 15 microg/l; p < 0.01). Serum HA levels correlated with the duration of chronic pancreatitis and with the levels of HA in pancreatic juice. HA and laminin were detected in the supernatants of pancreatic calculi (laminin 0.70 +/- 0.30 U/l; HA 275 +/- 85 microg/l). Immunocytochemically, strong staining for HAS was found in the duct epithelium and in centroacinar cells of chronic pancreatitis specimens.
Demonstration of increased amounts of HA in pancreatic juice of chronic pancreatitis patients stimulated with secretin suggests enhanced production of this ECM component in the chronically inflamed pancreas. The source of HA appears to be the pancreatic ductal epithelium.
纤维化的发展是慢性胰腺炎的特征。由于它是由细胞外基质（ECM）蛋白如透明质酸（HA）或层粘连蛋白的沉积导致的，在慢性胰腺炎过程中，这些ECM成分向血液或胰液中的释放可能会增加。
患者、材料与方法：使用针对HA和层粘连蛋白的免疫测定法，测量了20例慢性胰腺炎患者和20例非慢性胰腺炎患者的胰液和血清样本中这些ECM成分的浓度。还对从13例慢性胰腺炎患者获得的不同大小和重量的胰石进行了ECM成分含量的检测。用抗HA合成酶（HAS）抗体对正常胰腺组织样本和显示慢性胰腺炎的组织样本进行了免疫细胞化学研究。
用促胰液素刺激后，在慢性胰腺炎患者以及对照组的初始冲洗期发现了高水平的ECM成分。然而，慢性胰腺炎患者的HA水平比对照组高7倍（平均值±标准误；734±301对95±15μg/l；p<0.01）。血清HA水平与慢性胰腺炎的病程以及胰液中HA的水平相关。在胰石的上清液中检测到了HA和层粘连蛋白（层粘连蛋白0.70±0.30U/l；HA 275±85μg/l）。免疫细胞化学显示，在慢性胰腺炎标本的导管上皮和腺泡中心细胞中发现了HAS的强染色。
对用促胰液素刺激的慢性胰腺炎患者胰液中HA含量增加的证明表明，在慢性炎症的胰腺中这种ECM成分的产生增加。HA的来源似乎是胰腺导管上皮。
