lactoferrin and Pancreatitis--Chronic

The present review is focused on the clinical significance of lactoferrin in pancreatic secretions and stone formation in chronic pancreatitis, and of serum anti-lactoferrin antibody in autoimmune pancreatitis. Lactoferrin secretion is increased in pancreatic secretions in calcified and non-calcified chronic pancreatitis. Lactoferrin, pancreatic stone protein and trypsin are present in pancreatic stones. We cannot conclude which protein is more important for the precipitate and stone formation. The presence of antilactoferrin antibody has been reported in serum in autoimmune diseases, such as autoimmune pancreatitis. The coincidental appearance of autoimmune pancreatitis with extrapancreatic autoimmune diseases strongly suggests a common autoimmune mechanism and lactoferrin is a candidate antigen. Lactoferrin may play an important role as a precipitate protein in pancreatic stone formation in chronic pancreatitis and as an autoantigen in autoimmune pancreatitis. Further studies are required to better understand the role of lactoferrin.

Topics: Autoantibodies; Autoantigens; Autoimmune Diseases; Humans; Lactoferrin; Lithiasis; Pancreatitis, Chronic

Autoimmune pancreatitis (AIP) is a new clinical entity recently described. Histologically it consists of a lymphoplasmacytic infiltration with diffuse fibrosis. Pancreatic imaging on US, CT and ERCP shows diffuse enlargement of the pancreatic gland and an irregular narrowing of the pancreatic duct. Hypergammaglobulinemia, increased serum levels of total IgG or IgG4, positive antilactoferrin and anti carbonic anhydrase II autoantibodies are quite frequently found in autoimmune pancreatitis. Laboratory data, pancreatic images and diabetes mellitus improve under oral steroid therapy.

Topics: Age of Onset; Autoantibodies; Autoimmune Diseases; Carbonic Anhydrase II; Cholangiopancreatography, Endoscopic Retrograde; Female; Humans; Hypergammaglobulinemia; Lactoferrin; Male; Middle Aged; Pancreas; Pancreatitis, Chronic; Steroids

To determine the possible mechanism for chronic pancreatitis causing pancreatic duct stones.. A total of 172 patients with chronic pancreatitis (n=67), pancreatic duct stones (n=62), and pancreatic injury (n=43), admitted to from August 2000 to October 2008, preoperatively diagnosed by endoscopic retrograde cholangiopancreatograpby(ERCP) or computed tomography(CT), and intraoperatively confirmed by exploration and biopsy, were divided into 3 groups. Pancreatic fluid was drawn to test the concentrations of pancreatic stone protein (PSP), lactoferrin (LF) and Ca2+.. The chronic pancreatitis (the CP group) presented hard consistency, shrinkage and nodular fibrosis of the pancreas; besides the above symptoms, the pancreatic duct stones (the PS group) presented dilatation of the pancreatic ductal system with various stones; pancreatic injury (the PI group) presented broken pancreas of different grades with fluid or blood. Compared with that of the PI group, PSP concentration of both the PS group and the CP group was elevated (P<0.05), and was more apparent in the CP group. Concentrations of LF and Ca2+ were also elevated (P<0.05), which were more obvious in the PS group.. Decreased concentrations of PSP and increased concentrations of LF and Ca2+ may play very important roles in chronic pancreatitis causing pancreatic duct stones.

Topics: Adult; Aged; Calcium; Calculi; Female; Humans; Lactoferrin; Lithostathine; Male; Middle Aged; Pancreatic Diseases; Pancreatic Ducts; Pancreatic Juice; Pancreatitis, Chronic

Histopathological analysis has demonstrated lymphocytic infiltration in both the endocrine and the exocrine pancreas in some patients with type 1 diabetes and non-alcoholic chronic pancreatitis, suggesting an immune-mediated mechanism which affects both diabetes mellitus and chronic pancreatitis.. The examination of exocrine pancreatic humoral markers in Caucasian patients with respect to the interactions between exocrine and endocrine pancreatic diseases.. One hundred and thirty-six European Caucasian subjects subdivided into three groups: type 1 diabetes (n=48); non-alcoholic chronic pancreatitis (n=48); controls (n=40).. Autoantibodies against carbonic anhydrase II (CAIIAb) and lactoferrin (LACAb) (both of which are exocrine pancreatic antigens) were analyzed by enzyme-linked immunosorbent assay.. No positivity for CAIIAb and LACAb were found in the controls. Patients with type 1 diabetes had a significantly higher prevalence of CAIIAb (25.0%) than the controls while the prevalence of LACAb (8.3%) was not significantly higher than the controls. The prevalence of CAIIAb (12.5%) and LACAb (20.8%) in the patients with non-alcoholic chronic pancreatitis was significantly higher than that in the controls. A significantly higher prevalence of CAIIAb and/or LACAb was found in patients with type 1 diabetes (29.2%) and non-alcoholic chronic pancreatitis (22.9%) compared to that in the controls (0%). There was a significant association between CAIIAb and LACAb titers both in patients with type 1 diabetes (P=0.042) and in patients with non-alcoholic chronic pancreatitis (P<0.001).. We have clearly demonstrated that some European Caucasian patients with type 1 diabetes and non-alcoholic chronic pancreatitis have autoantibodies against the exocrine pancreatic antigens CAIIAb and LACAb.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Autoantibodies; Autoantigens; Carbonic Anhydrase II; Child; Child, Preschool; Diabetes Mellitus, Type 1; Enzyme-Linked Immunosorbent Assay; Europe; Female; Fluorescent Antibody Technique, Indirect; Glutamate Decarboxylase; Humans; Lactoferrin; Middle Aged; Pancreas, Exocrine; Pancreatitis, Chronic; Prospective Studies; Radioimmunoassay; White People; Young Adult

Although autoimmune pancreatitis (AIP) has been recently recognized as a new disease entity of chronic pancreatitis, the clinical diagnosis of the disease remains disputed. Autoantibodies against carbonic anhydrase II and lactoferrin are detected in most patients with AIP, but not in about 10%. We undertook this study to determine whether additional autoantibodies are present in the serum level of AIP patients.. We recruited 26 patients with AIP for the study. For comparison, we also recruited 53 patients with various pancreatic diseases and 12 healthy subjects. We immunoscreened human pancreatic cDNA library using patients' sera. Positive clones were analyzed by DNA sequencing and were constructed into a pGEX-4T-1 expression vector. The recombinant proteins were used as antigens in enzyme-linked immunosorbent assay to screen the subjects' sera for autoantibodies.. We cloned a cDNA encoding the pancreatic secretory trypsin inhibitor (PSTI). Among 26 patients with AIP, autoantibodies against PSTI were significantly positive in 11 (42.3%) by western blotting and in 8 (30.8%) by enzyme-linked immunosorbent assay, respectively. However, none of control subjects was positive for anti-PSTI antibodies.. These findings suggest that PSTI may be related to the pathogenesis of AIP, and autoantibodies against PSTI can be a useful diagnostic marker for the disease.

Topics: Aged; Autoantibodies; Autoimmune Diseases; Biomarkers; Carbonic Anhydrase II; Cloning, Molecular; Enzyme-Linked Immunosorbent Assay; Female; Glutathione Transferase; Humans; Lactoferrin; Male; Middle Aged; Pancreatitis, Chronic; Recombinant Fusion Proteins; Trypsin Inhibitor, Kazal Pancreatic