exenatide and Pancreatitis--Chronic

Incretin-based therapies have been associated with an increased risk of pancreatitis. Recently, various histological abnormalities have been reported in human pancreatic tissue from brain-dead organ donors who had been exposed to incretin-based drugs. In the present study we examined pancreatic tissue collected at surgery.. Human pancreatic tissue from 7 type 2-diabetic patients treated with incretin-based drugs (type 2-I), 6 diabetic patients without incretin treatment (type 2-NI), 11 patients without diabetes (no diabetes group) and 9 brain-dead organ donors (BDOD group) was examined.. Fractional beta-cell area was reduced in the type 2-NI group compared to the group without diabetes (P < .05), but there was no difference compared to the type 2-I patients. Alpha-cell area (P = .30), beta-cell replication (P = .17) and alpha-cell replication (P = .91) were not different. There were also no differences in acinar cell (P = .13) and duct cell replication (P = .099). Insulin-positive duct cells were more frequent in the type 2-I and the BDOD groups (P = .034). No co-expression of insulin and glucagon was detected. Pancreatic intraepithelial neoplasia (PanIN) lesions were very rare, all low-grade (PanIN 1a and 1b) and tended to occur more frequently in the type 2-I group (P = .084).. The present results did not reveal marked histological abnormalities in the pancreas of incretin-treated patients with type 2 diabetes. Low numbers of specimens available and a large inter-individual variability of the findings warrant caution regarding the interpretation of histological data concerning drug effects on the human pancreas.

Topics: Acinar Cells; Adamantane; Adenocarcinoma; Adult; Aged; Carcinoma in Situ; Case-Control Studies; Cystadenoma; Diabetes Mellitus, Type 2; Digestive System Surgical Procedures; Dipeptides; Exenatide; Female; Glucagon; Glucagon-Secreting Cells; Humans; Incretins; Insulin; Insulin-Secreting Cells; Islets of Langerhans; Male; Middle Aged; Neuroendocrine Tumors; Nitriles; Organ Size; Pancreas; Pancreas, Exocrine; Pancreatic Neoplasms; Pancreatitis, Chronic; Peptides; Pyrrolidines; Sitagliptin Phosphate; Tissue Donors; Venoms; Vildagliptin

The study aimed to explore exenatide-induced damage of pancreatic tissue in rats.. At first stage, 30 male rats were randomly divided into exenatide and control groups. At second stage, 10 male and 10 female rats were treated according to sex, exenatide dose and time, and with or without inhibitor. Exenatide was injected subcutaneously twice a day, and body weights were measured once a week. At approximately 10 weeks, blood and pancreatic tissue samples were harvested. Amylase, lipase, interleukin 1, interleukin 6, and tumor necrosis factor α in serums were determined. Pancreatic tissues were divided for dry-wet ratio, myeloperoxidase, hematoxylin-eosin staining, and electric microscope imaging.. Compared with the control group, myeloperoxidase in pancreatic tissue of rats administered with exenatide exhibited a significantly high level; dry-wet ratio of pancreatic tissue in rats administered with exenatide exhibited a significantly low level. Chronic pancreatic damage was observed in 30% of rats from exenatide group for both sexes and showed pycnosis of acinar cells, increased cytoplasmic vacuoles, widened cellular gap, and inflammatory cell infiltration in pancreatic tissue. No pancreatic damage was observed in the control and the inhibitor groups. Histopathological evaluation scores in exenatide group were significantly higher than those of the control group.. Long-term administration of exenatide in rats can result in chronic pancreatic damage.

Topics: Amylases; Animals; Cytokines; Exenatide; Female; Hypoglycemic Agents; Lipase; Male; Pancreas; Pancreatitis, Chronic; Peptide Fragments; Peptides; Peroxidase; Rats; Rats, Sprague-Dawley; Severity of Illness Index; Venoms