Role of NLR family pyrin domain-containing 3 inflammasome in the activation of pancreatic stellate cells

NLRP3 inflammasome activation plays an important role in the development of pancreatic fibrosis. However, it is unclear whether the activation of the NLRP3 inflammasome is directly involved in the activation of Pancreatic stellate cells (PSCs). The aim of this study was to investigate the role and mechanism of the NLRP3 inflammasome in the activation of PSCs. In vivo, a rat model of chronic pancreatitis (CP) was induced by intravenous injection of dibutyltin dichloride (DBTC). In vitro, rat primary PSCs were isolated from pancreatic tissues and incubated with the NLRP3 inflammasome activator LPS, the NLRP3 inhibitor MCC950, or NLRP3 siRNA. The results showed that the expression of NLRP3, pro-Caspase-1, Caspase-1 and IL-18 was increased in the rat model of CP and during PSCs activation. LPS increased the protein levels of NLRP3, ASC, Caspase-1, IL-1β and IL-18 accompanied by the upregulation of α-SMA, Col I and FN expression. Moreover, MCC950 or NLPR3 siRNA decreased the expression of α-SMA, Col I, FN, TGF-β1 and p-Smad3. Furthermore, MCC950 reversed the LPS-induced upregulation of α-SMA, FN and Col Ⅰ expression in PSCs. This study revealed that the NLRP3 inflammasome is directly involved in the activation of PSCs in vivo and in vitro. Inhibiting NLRP3 suppresses the activation of PSCs through the TGF-β1/Smad3 pathway.

Modified Da-chai-hu Decoction regulates the expression of occludin and NF-κB to alleviate organ injury in severe acute pancreatitis rats

Modified Da-chai-hu Decoction (MDD), a traditional Chinese medicinal formulation, which was empirically generated from Da-chai-hu decoction, has been utilized to treat severe acute pancreatitis (SAP) for decades. The aim of the present study was to explore its potential organprotective mechanism in SAP. In the present study, rat SAP model was induced by retrograde injection of 3.5% sodium taurocholate into the biliopancreatic duct, MDD (23.35 g/kg body weight, twelve times the clinical dose) were orally given at 2 h before and 10 h after injection. At 12 h after model induction, blood was taken from vena cava for analysis of amylase, diamine oxidase (DAO), pulmonary surfactant protein-A (SP-A), and C-reactive protein (CRP). Histopathological change of pancreas, ileum and lung was assayed by H&E staining, myeloperoxidase (MPO) activity were determinated using colorimetric assay, and the expressions of occludin and nuclear factor-κB (NF-κB) were detected by real-time RT-PCR and western blot, respectively. In addition, the tissue concentrations of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and monocyte chemoattractant protein-1 (MCP-1) were measured by enzyme-linked immunosorbent assay (ELISA). The results showed that in SAP rats, MDD significantly alleviated histopathological damage, depressed the MPO activity and the concentrations of TNF-α, IL-1β, and MCP-1 of pancreas, ileum and lung, and reduced the serum levels of amylase [(3283.4 ± 585.5) U·L^-1vs (5626.4 ± 795.1)U·L^-1], DAO [(1100.1 ± 334.3) U·L^-1vs (1666.4 ± 525.3) U·L^-1] and CRP [(7.6 ± 1.2) μg·mL^-1vs (17.8 ± 3.8) μg·mL^-1]. However, the serum SP-A concentration [(106.1 ± 16.6) pg·mL^-1vs (90.1 ± 14.9) pg·mL^-1] was elevated when treated SAP rats with MDD. Furthermore, MDD increased the occludin expression and reduced the NF-κB expression in pancreas, ileum and lung of SAP rats. Our findings suggested that MDD administration was an effective therapeutic approach for SAP treatment. It could up-regulate occludin expression to protect intercellular tight junction and down-regulate NF-κB expression to inhibit inflammatory reaction of pancreas, ileum and lung.

Saikosaponin d ameliorates pancreatic fibrosis by inhibiting autophagy of pancreatic stellate cells via PI3K/Akt/mTOR pathway

Chronic pancreatitis is characterized by pancreatic fibrosis, associated with excessive activation of pancreatic stellate cells (PSCs) and increased expression of transforming growth factor-β1 (TGF-β1). Recently, our studies have shown that autophagy inhibitor could inhibit PSCs activation and reduce collagen secretion. Saikosaponin d (SSd), the major active component of bupleurum falcatum (a medicinal plant), has anti-fibrosis effects in liver. However, it is unclear whether SSd has a role in pancreatic fibrosis. This study aimed to investigate the effect of SSd on the autophagy and activation of PSCs in vivo and in vitro. In vivo, a rat chronic pancreatitis model was induced by intravenous injection of dibutyltin dichloride. SSd was administered at a dose of 2.0 mg/kg body weight per day by gavage. After 4 weeks, the pancreas was collected for histological and molecular analysis. In vitro, PSCs were isolated and cultured for treatment with different dosages of SSd. The results showed that SSd inhibited PSCs autophagy and activation while also reducing extracellular matrix (ECM) formation and pancreatic damage. SSd inhibited autophagy through activating the PI3K/Akt/mTOR pathway. SSd also promoted degradation of ECM with an increasing ratio of MMPs/TIMPs and suppressed the TGF-β1/Smads pathway. From these results, we concluded that SSd prevents pancreatic fibrosis by reducing autophagy of PSCs through PI3K/Akt/mTOR pathway, which has crosstalk with the TGF-β1/Smads pathway.

Papillary balloon dilatation combined with endoscopic sphincterotomy for treatment of common bile duct stones: Efficacy and factors affecting stone recurrence

AIM

To evaluate the efficacy of endoscopic papillary balloon dilatation (EPBD) combined with endoscopic sphincterotomy (EST) in the treatment of common bile duct stones and to identify the factors affecting the recurrence of stones.

METHODS

One hundred patients with choledocholithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP) at our hospital between January 2014 and January 2016 were randomly divided into a control group and an experimental group. The patients in the control group and experimental group were given EST lithotomy and small-incision endoscopic sphincterotomy (SEST) combined with EPBD, respectively. The one-time success rate, total success rate, and the incidence of complications after ERCP were comparatively analyzed. The Kaplan-Meier survival curve of patients with postoperative stone recurrence was plotted, and the Cox regression model was used to explore the risk factors for postoperative recurrence in patients.

RESULTS

The maximum diameter of the stones (t = -1.055, P = 0.294), the rate of multiple stones (χ² = 0.644, P = 0.422), the maximum diameter of bile duct (t = -0.820, P = 0.414), and the stone removal success rate (94.0% and 100.0%, χ² = 1.375, P = 0.241) differed significantly between the control group and the experimental group. There was no significant difference in the one-time success rate between the control group and the experimental group (84.0% and 96.0%, χ² = 4.332, P = 0.037). The incidence of complications after ERCP in the control group and experimental group was 17.02% and 6.0%, respectively (χ² = 4.337, P = 0.036). A total of 97 patients were followed, with stone recurrence occurring in 11 cases. In the 97 patients followed, the incidence of complications after ERCP in the control group and experimental group was 17.02% and 6.0%, respectively (χ² = 2.927, P = 0.087). Log-rank test showed that the risk of gallstone recurrence in the experimental group was significantly lower than that in the control group (HR = 0.285, 95%CI: 0.095-0.888, P = 0.044). Multivariate Cox regression analysis showed that multiple endoscopic procedures, common bile duct angulation (≤ 145°), and EST were risk factors for ERCP recurrence.

CONCLUSION

The success rate and safety of EPBD combined with LEST in the management of common bile duct stones are high, and the risk of long-term stone recurrence is low. Multiple endoscopic operations and common bile duct angulation (≤ 145°) are risk factors for stone recurrence.

Comparison of endoscopic ultrasound-guided drainage with surgery for treatment of pancreatic pseudocysts: Analysis of 70 cases

AIM: To compare surgical treatment versus endoscopic ultrasound-guided drainage for treatment of pancreatic pseudocysts regarding clinical success, complication rate, recurrence, hospital stay and cost.

METHODS: Seventy cases of pancreatic pseudocysts were retrospectively studied at our hospital from January 2012 through January 2015, of which 24 (group A) were drained under the guidance of endoscopic ultrasound and 46 (group B) were drained surgically. The clinical success, complication rate, recurrence, hospital stay and cost were compared between the two groups.

RESULTS: The complication rate was significantly lower in group A than in group B (12.5% vs 30.4%, P < 0.05). The hospital stay in group A was significantly shorter than that in group B (3.1 d ± 1.7 d vs 7.5 d ± 2.2 d, P < 0.05). Likewise, the cost was significantly lower in group A than in group B (1056 yuan ± 856 yuan vs 2349 yuan ± 457 yuan, P < 0.05). The clinical success, recurrence, and mortality rates were similar in both groups (P > 0.05).

CONCLUSION: Endoscopic treatment of pancreatic pseudocysts offers the same clinical success, recurrence, and mortality rates as surgical treatment but with a lower complication rate, and shorter hospital stay and lower costs.

Relationship between the degree of severe acute pancreatitis and patient immunity

PURPOSE

To investigate the relationship between the APACHE II score and the immunity of patients with severe acute pancreatitis.

METHODS

Clinical data were collected from 88 patients with acute pancreatitis, divided into four groups according to the severity of the disease. C-reactive protein (CRP), tumor necrosis factor-α, interleukin-6, interleukin-10, interleukin-4 and endotoxin (ET) in serum were measured on admission and then on days 3, 5, and 7.

RESULTS

The incidence of local complications and multiple organ dysfunction syndrome increased with a higher APACHE II score. The CRP levels were increased significantly on day 3 in all four groups, but remained high only in the extremely severe group. In the mild and moderate groups, the pro-/anti-inflammatory cytokines peaked on day 3 and then decreased slowly. In the severe and extremely severe groups, the proinflammatory cytokines levels peaked on days 3 and 5, and then decreased rapidly. The antiinflammatory cytokines increased progressively on days 3, 5 and 7. The ET levels peaked significantly and then decreased slowly in the mild, moderate and severe groups, but remained high in the extremely severe group.

CONCLUSIONS

An APACHE II score of 16 or higher is predictive of more local and systemic complications, excessive immune response, and premature immunosuppression.

Phasic study of intestinal homeostasis disruption in experimental intestinal obstruction

AIM: To investigate the phasic alteration of intestinal homeostasis in an experimental model of intestinal obstruction.

METHODS: A rabbit model of intestinal obstruction was established by transforming parts of an infusion set into an in vivo pulled-type locking clamp and creating a uniform controllable loop obstruction in the mesenteric non-avascular zone 8 cm from the distal end of the ileum. The phasic alteration of intestinal homeostasis was studied after intestinal obstruction. The changes in goblet cells, intraepithelial lymphocytes, lamina propria lymphocytes, and intestinal epithelium were quantified from periodic acid-Schiff-stained sections. Ornithine decarboxylase (ODC) activity and serum citrulline levels were measured by high-performance liquid chromatography. Claudin 1 mRNA expression was examined by real-time polymerase chain reaction analysis. Intestinal microorganisms, wet/dry weight ratios, pH values, and endotoxin levels were determined at multiple points after intestinal obstruction. Furthermore, the number and ratio of CD3⁺, CD4⁺ and CD8⁺ T cells were determined by flow cytometry, and secretory IgA levels were measured with an enzyme-linked immunosorbent assay.

RESULTS: A suitable controllable rabbit model of intestinal obstruction was established. Intestinal obstruction induced goblet cell damage and reduced cell number. Further indicators of epithelial cell damage were observed as reduced serum citrulline levels and claudin 1 gene expression, and a transient increase in ODC activity. In addition, the wet/dry weight ratio and pH of the intestinal lumen were also dramatically altered. The ratio of Bacillus bifidus and enterobacteria was reversed following intestinal obstruction. The number and area of Peyer’s patches first increased then sharply decreased after the intestinal obstruction, along with an alteration in the ratio of CD4/CD8⁺ T cells, driven by an increase in CD3⁺ and CD8⁺ T cells and a decrease in CD4⁺ T cells. The number of lamina propria lymphocytes also gradually decreased with prolonged obstruction.

CONCLUSION: Intestinal obstruction can induce disruption of intestinal homeostasis.

Intravenous infusion of mesenteric lymph from severe intraperitoneal infection rats causes lung injury in healthy rats

AIM: To investigate whether mesenteric lymph from rats with severe intraperitoneal infection (SII) induces lung injury in healthy rats.

METHODS: Twenty adult male specific pathogen-free Wistar rats were divided into two groups. Animals in the SII group received intraperitoneal injection of Escherichia coli (E. coli) at a dose of 0.3 mL/100 g. Control rats underwent the same procedure, but were injected with normal saline rather than E. coli. We ligated and drained the mesenteric lymphatic vessels and collected the mesenteric lymph. Mesenteric lymph collected from SII or control rats was infused intravenously into male healthy rats at a rate of 1 mL/h for 4 h. At the end of the infusion, all rats were sacrificed. Lungs were removed and examined histologically, and wet-to-dry weight (W/D) ratio and myeloperoxidase (MPO) activity were determined. Enzyme-linked immunosorbent assay (ELISA) was performed to determine the levels of the proinflammatory cytokines tumor necrosis factor (TNF)-α and interleukin (IL)-6. We performed Western blot to investigate the activation of Toll-like receptor (TLR)-4, and nuclear factor (NF)-κB p65.

RESULTS: Compared with the control infusion group, there were obvious pathological changes in the SII group. The W/D ratio was significantly increased in the SII compared to control infusion group (5.86 ± 0.06 vs 5.37 ± 0.06, P < 0.01). MPO activity significantly increased in the SII infusion rats with a mean level of 0.86 ± 0.02 U/g compared to 0.18 ± 0.05 U/g in the control group (P < 0.01). The concentrations of TNF-α and IL-6 were significantly increased in the SII infusion group. The concentration of TNF-α was significantly increased in the SII infusion rats compared to control infusion rats (2104.46 ± 245.91 vs 1475.13 ± 137.82 pg/mL, P < 0.01). The concentration of IL-6 was significantly increased in the SII infusion rats with a mean level of 50.56 ± 2.85 pg/mL compared to 43.29 ± 2.02 pg/mL (P < 0.01). The expression levels of TLR-4 (7496.68 ± 376.43 vs 4589.02 ± 233.16, P < 0.01) and NF-κB (8722.19 ± 323.96 vs 6498.91 ± 338.76, P < 0.01) were significantly increased in the SII infusion group compared to the control infusion group. The infusion of SII lymph, but not control lymph, caused lung injury.

CONCLUSION: The results indicate that SII lymph is sufficient to induce acute lung injury.

Clinical observation of immunity for severe acute pancreatitis

The aim of our study was to observe the dynamic changes of immunity for patients with severe acute pancreatitis (SAP) and intervention by traditional Chinese medicine. Twenty-three patients who met the inclusion criteria were randomized to combined treatment of traditional Chinese medicine and Western medicine (TCM) or conventional western medicine treatment (WM) groups. The clinical data for all patients were collected. Peripheral venous blood samples were obtained from patients on days 1, 7, 14, and 28 after admission. Biochemical data including the percentage of CD4+/CD8+/natural killer (NK) cells/B lymphocytes/HLA-DR and CD4+/CD8+ ratio in serum were determined by flow cytometer. Patients' characteristics and immunity at admission were similar between the two groups. The secondary infection was different. The levels of T-lymphocyte subsets in the TCM group were quite different from the WM group, with much more the percentage of CD4+ and the CD4+/CD8+ ratio on days 7, 14, and 28 and much less the percentage of CD8+ on days 4 and 28. On days 14 and 28, the levels of NK cells and B lymphocytes were significantly higher in the TCM group compared with the controls. Compared with the TCM group, the levels of HLA-DR were significantly decreased in the WM group on days 7, 14, and 28. The immune dysregulation exists in the development and progression of SAP. The combined treatment of traditional Chinese medicine and western medicine can upregulate the patient's immune and maintain the immune balance.

Predisposing factors to infection secondary to severe acute pancreatitis: an analysis of 42 cases

AIM: To conduct a systematic evaluation of predisposing factors to infection secondary to severe acute pancreatitis (SAP).

METHODS: The clinical data for 42 patients with infection secondary to SAP who were treated from January 2000 to January 2008 at Tianjin Nankai Hospital were retrospectively analyzed. Univariate and multivariate models were used to find predisposing factors to infection secondary to SAP.

RESULTS: The interval between onset and admission (effective treatment time), APACHE-Ⅱscore, CT score, PO₂, intestinal function recovery time, and BE were significantly associated with the development of secondary infection in patients with SAP (OR = 2.846, 7.286, 34.833, 0.350, 24.273, 0.194, all P < 0.05).

CONCLUSION: The time from onset to admission, APACHE-Ⅱ score, CT score, PO₂, intestinal function recovery time, and BE are predisposing factors to infection secondary to SAP.

Immune dysregulation in patients with severe acute pancreatitis

To investigate patients with severe acute pancreatitis (SAP) by dynamic levels of pro-/anti-inflammatory cytokines and endotoxin (ET) in plasma and the relationship between immunity and infection, organ dysfunction. Seventy-two patients with SAP were recruited. The ET, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), and interleukin-4 (IL-4) were determined on admission and days 3, 7, and 14. For comparison, patients were analyzed through infection group versus non-infection group, multiple organ dysfunction syndrome (MODS) group versus non-MODS group. There were sixteen patients with secondary infection, twenty-two with MODS, and nine deaths. The infection group had higher levels of ET than the non-infection group on days 3 and 7. The dynamic cytokine levels of patients in the MODS group were unanimous with those outcomes in the infection group. The levels of cytokines in the infection group were different from the non-infection group, with more levels of TNF-α, IL-6 on days 3 and 7 and less on days 14, and more levels of IL-10, IL-4 on days 7 and 14. The levels of TNF-α, IL-6 in the MODS group were different from the non-MODS group, with more levels on days 3 and 7, and less levels on days 14. Immune dysregulation may play an important role in infection and organ dysfunction for patients with SAP.

Overexpression of Sterol Carrier Protein 2 in patients with hereditary cholesterol gallstones

BACKGROUND

Lithogenic bile is the major cause of cholesterol gallstone, but its pathogenesis is not well understood. The hypersecretion of biliary cholesterol is believed to be an important cause of lithogenic bile. Sterol Carrier Protein 2 (SCP2) participates in cholesterol trafficking and lipid metabolism in hepatocytes and may play a key role in cholesterol gallstone formation.

METHODS

21 cholesterol gallstone genealogies were studied to investigate the expression of SCP2 gene in liver tissue of hereditary and non-hereditary cholesterol gallstone patients as well as non-gallstone patients. The mRNA expression of liver SCP2 in 28 hereditary patients, 30 non-hereditary cholesterol gallstone patients and 32 non-gallstone patients was measured by Reverse Transcription Polymerase Chain Reaction (RT-PCR). The protein expression of liver SCP2 was also detected in all the patients by Western blotting. At the same time, the bile was also analyzed with biochemical techniques and the Cholesterol Saturation Index (CSI) was calculated.

RESULTS

The mRNA and protein expression of SCP2 was significantly increased in cholesterol gallstone patients compared to those of non-gallstone patients. Moreover, SCP2 was expressed at higher levels in hereditary cholesterol gallstone patients than that of non-hereditary cholesterol gallstone patients. There was significant difference observed in CSI between cholesterol gallstone patients and non-gallstone patients, but not in CSI between hereditary and non-hereditary cholesterol gallstone patients.

CONCLUSIONS

SCP2 was overexpressed in hereditary cholesterol gallstone patients compared to non-hereditary cholesterol gallstone patients. This finding indicated that SCP2 might be one of the genetic factors contributing to cholesterol gallstone formation, which was always accompanied by the increase of bile lithogenicity.

Therapeutic effect of pancreas clearing tablets (Qingyi pian) on severe acute pancreatitis

AIM: To explore the therapeutic effect of pancreatic clearance pills (Qingyi pian) on severe acute pancreatitis.

METHODS: From January 1997 to December 2007, 272 cases of severe acute pancreatitis were randomly divided into traditional Chinese medicine group and control group. Their recurrence and nutritional status were recorded.

RESULTS: The 1-year AP recurrence rate after discharge was 46.3% (126/272). The 1-year AP recurrence rate of the Chinese medicine group was significantly lower than that of the control group (39.9% vs 53.0%, P < 0.05). Nutritional damage score at 6 and 12 mo after discharge was significantly lower in Chinese herb group than in the control group (t = 2.23, 2.77, P < 0.05 or 0.01).

CONCLUSION: Use of pancreatic clearance pills within the first 3 months after discharge reduces long-term AP recurrence rate and improves nutritional status for SAP patients.

Systematic evaluation of the therapeutic efficacy of Tongli Gongxia herbs on severe acute pancreatitis

AIM: To evaluate therapeutic efficiency of Tongli Gongxia treatments for severe acute pancreatitis.

METHODS: Tongli Gongxia treatment for severe acute pancreatitis (SAP) of randomized clinical trial (RCT) literature was retrieved in domestic biological medicine journals during 2004-01 and 2008-12. According to selection and exclusion standard, eight clinical trials (a total 628 cases of SAP, 293 cases of Chinese medicine treatment group and 335 cases of the control group) were enrolled in the study. First defecation time, hospitalization, mortality, complication rate and operability were analyzed using Meta Analysis. Results analysis was performed using RevMan 4.2 software.

RESULTS: First defecation time and days of hospitalization were significantly shorter in Chinese medicine treatment group than control group (SMD = -2.34, -1.91, both P < 0.01). Operability, complication rate and mortality rate were significantly lower in Chinese medicine treatment group than the control group (OR = 0.36, 0.41, 0.31, all P < 0.01).

CONCLUSION: Tongli Gongxia treatment can shorten first defecation time, hospitalization and reduce the operability, complication rate, and mortality in the patients with severe acute pancreatitis.

[Relationship between immune imbalance and sthenia-asthenia syndromes in patients suffering from severe intra-abdominal infection]

OBJECTIVE

To explore the characteristics of immune imbalance in patients with multiple organ dysfunction syndrome (MODS) induced by severe intra-abdominal infection and its relationship with changing of TCM sthenia-asthenia syndrome.

METHODS

Forty-six patients with MODS induced by severe intra-abdominal infection and treated with etiological and syndrome differentiation of integrative medicine were observed in succession. Patients' peripheral blood levels of interleukin-6/interleukin-10 ratio (IL-6/IL-10), human leukocyte antigen DR site (HLA-DR), helper T lymphocyte1/2 ratio (Th1/Th2), and the regulatory T lymphocyte (Treg) were measured on the 1st, 3rd and 7th day of the research respectively. And the distribution laws of TCM syndrome types, sthenia (S), asthenia (A), and mingled sthenia/asthenia (M), in patients were observed as well.

RESULTS

IL-6/IL-10 ratio at all the testing time points showed insignificant difference in patients of types S and M, while in those of type A, it was more lowered on the 7th day than that on the 1st day. HLA-DR lowered to <30% on the 7th day in all patients of type A and showed significant difference to that on the 1st day (P <0.05), while HLA-DR <30% was not found in all patients of types S and M. Th1/Th2 ratio in patients of types S and A was insignificant different at the foremost 3 days, but lowered significantly on the 7th day, while in patients of type M, it was unchanged in all the 7 days of observation. Treg level was unchanged in the foremost 3 days in patients of types S and M, while in those of type A, it raised on the 3rd day, but no raising was found in the subsequent 4 days. Comparisons of various indexes detected at corresponding time points respectively among patients with various syndrome types showed that, for levels of IL-6/IL-8, HLA-DR, and Th1/Th2, the sequence was S>M>A; and for Treg, it was A>M>S.

CONCLUSION

In the pathological process of MODS induced by severe intra-abdominal infection, the index IL-6/IL-10, reflecting the balance of the pro-/anti-inflammatory cytokines and the indexes HLA-DR, Th1/Th2 and Treg reflecting the immune function, all can exactly reflect the TCM asthenia-sthenia syndrome types. The sequence in patients of various syndrome types for levels of IL-6/IL-10, HLA-DR and Th1/Th2, is S> M>A, but for Treg it is the inverse, as A>M>S.

Role of Kupffer cells in acute hemorrhagic necrotizing pancreatitis-associated lung injury of rats

AIM: To investigate the role of Kupffer cells (KCs) in acute hemorrhagic necrotizing pancreatitis-associated lung injury (AHNP-LI).

METHODS: Forty-two rats were allocated to four groups [sham operation, AHNP model, gadolinium chloride (GdCl₃) pretreatment, GdCl₃ control]. In GdCl₃ pretreatment group, GdCl₃ was administered by caudal vein injection 24 h before the AHNP model induction. Blood from the iliac artery, alveolar macrophages and tissues from the pancreas and lung, were collected in six animals per group 3 and 6 h after acute pancreatitis induction. TNF-α, IL-1 of serum, myeloperoxidase (MPO) of lung tissue, NF-κB activation of alveolar macrophages were detected. Serum AST and ALT in sham operation group and GdCl₃ control group were tested. In addition, histopathological changes of the pancreas and lung were observed under light microscope.

RESULTS: MPO of lung tissue and TNF-α, IL-1 levels of serum were all reduced significantly in GdCl₃ pretreatment group compared to those in AHNP group (P <0.01). NF-κB activation of alveolar macrophages was also attenuated significantly in GdCl₃ pretreatment group compared to that in AHNP group (P <0.01). The pathological injury of the lung was ameliorated obviously in GdCl₃ pretreatment group compared to that in AHNP group. Nevertheless, the serum amylase level did not reduce and injury of the pancreas was not prevented in GdCl₃ pretreatment group.

CONCLUSION: Pulmonary injury induced by AHNP is mediated by KC activation and AHNP-LI can be significantly ameliorated by pretreatment with GdCl₃ and KCs play a vital role in AHNP-LI.

Upregulation of human telomerase reverse transcriptase mRNA expression by in vitro transfection of hepatitis B virus X gene into human hepatocarcinoma and cholangiocarcinoma cells

AIM: To study the changes of human telomerase reverse transcriptase (hTERT) mRNA expression in human hepatocarcinoma cell lines (HepG2) and cholangiocarcinoma cell lines (QBC939) after HBx gene transfection and to illustrate the significance of transcriptional regulation of hTERT gene by HBx gene in the carcinogenesis.

METHODS: HepG2 and QBC939 cell lines were cultured and co-transfected with eukaryotic expression vector containing the HBx coding region and cloning vector containing enhanced green fluorescent protein (EGFP) coding sequence using lipid-mediated gene transduction technique. Thirty-six hours after transfection, EGFP expression in cells was used as the indicator of successful transfection. Flow cytometry was performed to determine the transfection efficiency. Cells were harvested and total RNA was extracted using TRIzol^® reagent. The expression of hTERT mRNA in HepG2 and QBC939 cell lines was assayed by reverse transcription-polymerase chain reaction. The expression of HBx protein in both cell lines was detected by immunocytochemical staining and Western blotting.

RESULTS: Flow cytometry showed that the transfection efficiency was 46.4% in HepG2 cells and 29.6% in QBC939 cells for both HBx gene expression vector and blank vector. The expression of hTERT mRNA was meaningfully increased in HepG2 and QBC939 cell lines when transfected with HBx gene expression vector compared to those transfected with OPTI-MEM medium and blank vector. Immunocytochemical staining and Western blotting revealed HBx protein expression in HepG2 and QBC939 cells only when transfected with HBx gene.

CONCLUSION: HBx gene transfection can upregulate the transcriptional expression of hTERT mRNA. The transactiv-ation of hTERT gene by HBx gene is a newfound mechanism for pathogenesis of hepatocarcinomas and cholangioca-rcinomas after HBV infection.

Expression of HMGCR, SCP2 mRNA in hereditary cholesterol gallstone patients

AIM: To investigate the expression of the genes for HMGcoA reductase (HMGCR) and sterol carrier protein-2 (SCP₂) in the livers of patients with hereditary and non-hereditary cholesterol gallstone, as well as non-cholesterol gallstone.

METHODS: The mRNA expression levels of the liver HMGCR and SCP₂ genes were determined by RT-PCR in 28 patients with hereditary cholesterol gallstone, 30 patients with non-hereditary cholesterol gallstone, and 32 patients with non-cholesterol gallstone.

RESULTS: The mRNA expression levels of HMGCR in hereditary and non-hereditary cholesterol gallstone patients were 1.9 269±0.2 134 and 1.9 791±0.2 524, respectively, both increased significantly (P<0.05) as compared with that in the non-cholesterol gallstone patients (0.7 730±0.1 530). The levels of SCP₂ mRNA in hereditary and non-hereditary cholesterol gallstone patients were 0.8 908±0.1 649 and 0.7 503±0.1 004, both increased significantly (P<0.05) as compared with non-cholesterol gallstone patients (0.5 205±0.1 900). Moreover, there was also a significant increase of SCP₂ mRNA in hereditary cholesterol gallstone patients as compared with non-hereditary cholesterol gallstone patients (P<0.05).

CONCLUSION: HMGCR and SCP₂ are overexpressed in cholesterol gallstone patients, which may be an important cause of cholesterol gallstones.

Overexpression of sterol carrier protein-2 mRNA in patients with cholesterol gallstones

BACKGROUND

Hypersecretion of biliary cholesterol is believed to be one of the important causes of lithogenic bile. Sterol carrier protein-2(SCP2) participates in cholesterol trafficking and metabolism and may play a key role in cholesterol gallstone formation. This study was undertaken to investigate the expression of liver SCP2 mRNA in patients with cholesterol gallstone and those patients with non-cholesterol gallstone.

METHODS

The expression of liver SCP2mRNA was studied in 36 patients with cholesterol gallstone and 30 patients with non-cholesterol gallstone by reverse transcription-polymerase chain reaction (RT-PCR).

RESULT

The expression of SCP2 mRNA was increased more significantly in patients with cholesterol gallstone than in patients with non-cholesterol gallstone.

CONCLUSION

The SCP2 gene was overexpressed in patients with cholesterol gallstone, indicating that SCP2 may be one of the important causes of cholesterol gallstone.

[Effect of li dan ling in decreasing jaundice and improving liver function in patients with obstructive jaundice]

A total of 89 cases with extrahepatic jaundice were studied clinically. All patients were divided into two groups at random: control group and Li Dan Ling treatment group. It was found that: (1) liver functions in the patients with obstructive jaundice were injured severely; bilirubin, R15ICG, m-GOT, and gamma-GT were increased significantly; (2) in patients with incomplete biliary obstruction or after the relief of obstruction, liver functions could be improved gradually. They were improved more quickly in patients of the Li Dan Ling treatment group; (3) for the patients suffering from complete biliary tract obstruction, until the obstruction was relieved liver function could not be improved. After the herbal medicine, all the indicators would be further worsened before the relief of the obstruction, and the value of "b" would be positive. The increase in m-GOT and gamma-GT was higher than in the control group, indicating the liver functions were further injured. Therefore, the herbal cholegogue was not suitable for the patients before the obstruction was relieved. The further investigations showed that excretion of bilirubin from the bile could be accelerated by Li Dan Ling, and after herbal administration, the cholesterol level in bile was lowered significantly; the liver blood flow in normal and jaundiced rats would be increased 30 to 90 min. after administering the herbs.