trypsinogen and Cholestasis

The aim of this study was to examine the effect of the most potent CCK receptor antagonist, L364,718, on two major factors involved in pancreatitis development: enzyme load and cytosolic calcium (Ca2+) levels in acinar cells. L364,718 (0.1 mg/kg/12 hr) was administered from 30 min before inducing acute pancreatitis (AP) by pancreatic duct obstruction (PDO) for 48 hr. The results obtained at different AP stages in PDO rats treated and not treated with the CCK antagonist were compared. Similar increases in the intracellular enzyme content were found at earlier stages of pancreatitis in all PDO rats treated or not treated with L364,718. The CCK antagonist increased cytosolic Ca2+ levels up to 6 hr after administration, inducing a higher cytosolic Ca2+ overload at the earliest stages of pancreatitis in L364,718-treated PDO rats than in those not treated. This event might justify the higher increases in ascites volume and haematocrit found in PDO rats treated with L364,718 and the exacerbation in pancreatic morphological alterations induced by PDO. The CCK receptor antagonist L364,718 produces alterations in the acinar calcium homeostasis that prevent to reduction in the severity of pancreatitis induced by obstruction.

Topics: Acute Disease; Amylases; Animals; Calcium; Cholecystokinin; Cholestasis; Devazepide; Hormone Antagonists; Male; Pancreas; Pancreatic Ducts; Pancreatitis; Rats; Rats, Wistar; Trypsinogen

Authors report two cases of childhood chronic pancreatitis, causing severe symptoms and common bile duct stenosis with cholestasis. Both patients had to be operated on. Chronic pancreatitis with calcification led to significant common bile duct stenosis in a 13 years old girl. After ERCP a double bypass procedure was performed (Wirsungo-jejunostomy and hepatico-jejunostomy). During 42 months follow-up the patient remained pain- and symptom-free gaining 16 kilograms. In a 9 years old girl severe stenosis of the intrapancreatic common bile duct and a small duct type chronic pancreatitis with extensive fibrosis was found. Treatment was Roux-en-Y hepatico-jejunostomy. Thirty-four months after the operation she is symptom-free with normal enzyme parameters. Authors report results of genetic investigations performed on registered chronic pancreatitis children and their families in Hungary, including the two operated cases. Two of the 5 patients were hereditary type, despite negative family history. Cationic trypsinogen gene R122H (R117H) mutation were detected in both patients. Chronic non-hereditary pancreatitis is a very rare disease in childhood but may cause severe secondary conditions requiring surgery.

Topics: Adolescent; Biliary Tract Surgical Procedures; Child; Cholestasis; Chronic Disease; Common Bile Duct; Constriction, Pathologic; Female; Fibrosis; Humans; Hungary; Male; Mutation; Pancreatitis; Trypsinogen

This study was conducted to investigate the role of humoral factors in pancreatic alterations induced by obstructive jaundice (OJ) in rats. OJ in male Sprague-Dawley rats induced significant increases in pancreatic weight, DNA content, and RNA content of acinar cells. These changes were accompanied by enlargement of eosinophilic granules and compressed nuclei. Protein, amylase, and trypsinogen contents of pancreas were also increased in OJ rats. In addition, plasma levels of bilirubin, cholecystokinin (CCK), and estradiol increased in OJ rats and were correlated positively with each other and with pancreatic weights. Administration of a specific CCK receptor, L-364,718, to OJ rats partly attenuated the changes of the pancreas, indicating that CCK is involved in these changes. These findings suggest that estradiol may be involved in regulating the pancreatic changes induced by OJ in rats.

Topics: Amylases; Animals; Cholecystokinin; Cholestasis; Estradiol; Male; Pancreas; Proteins; Rats; Rats, Sprague-Dawley; Trypsinogen

After 48 h of bile duct ligation, enterokinase activity in rat mucosa was significantly lowered in comparison with controls or rats with bile fistula. Rats with bile fistula were similar to controls. Sucrase levels were similar in all groups. Without endogenous trypsinogen, duodenal perfusion with a trypsinogen-containing solution led to more conversion to trypsin by controls. When their own pancreatic secretion was the source of trypsinogen, trypsin was much higher in perfusate from bile-ligated rats. Solubilized enterokinase was also higher in this group. These results indicate that bile stasis leads to decreased mucosal enterokinase activity and increased pancreatic function. The latter may have caused accelerated loss of enterokinase into the lumen, leading to lower mucosal levels.

Topics: Animals; Bile Ducts; Biliary Fistula; Cholestasis; Endopeptidases; Enteropeptidase; Intestinal Mucosa; Ligation; Male; Pancreas; Perfusion; Rats; Sucrase; Trypsin; Trypsinogen