Search

Resveratrol, which is thought to have a preventive effect on the formation of different types of cancer, is abundant in grapes and other foods. Resveratrol has been shown to have anti‐cancer effects by in vitro andin vivo studies, however this is the first time its effect on atypical acinar cell foci (AACF), known as precursor forms of pancreatic carcinoma, has been experimentally investigated. Male Sprague Dawley rats, each consisting of 5 experimental groups (Cont, AzCont, AzRes10, AzRes15, and AzRes20), 10 of which were 14 days old, were used in the study. In the azaserine groups (AzCont, AzRes10, AzRes15, and AzRes20), it was investigated how the development of Atypical Cell Foci (AACF) resulting from intraperitoneal injection (i.p.) of azaserine (30 mg/kg bw) in 14‐day‐old rats was affected by dietary restoration. Male rats in the resveratrol group (AzRes10, AzRes15, and AzRes20) were fed diets containing 10%, 15%, or 20% mmol resveratrol for an 8‐month experimental period 1 week after the last azaserine injection. Pancreas preparations prepared from histological sections were examined for AACF burden and analyzed via a video image analyzer. One‐way analysis of variance (ANOVA) non‐parametric statistical analyses were performed to test whether there was a difference between the averages of the experimental and control groups. The AACF load in the azaserine group (AzCont) compared to the control group (Cont) was found to be statistically significant in all categories (p < 0.05). The calculated estimated mean AACF volume (mm3) values and the AACF ratio as a percentage of the calculated organ volume were statistically significantly lower in all resveratrol groups (AzRes10, AzRes15, and AzRes20) compared to the azaserine control group (AzCont). The calculated estimated mean AACF volume (mm3) values and the AACF ratio as a percentage of the calculated organ volume were statistically significantly lower in all resveratrol groups (AzRes10, AzRes15, and AzRes20) compared to the azaserine control group (AzCont) (p < 0.05). In addition, the calculated estimated mean AACF diameter (mm) in the AzRes10 and AzRes15 groups, in the AzRes15 group the calculated estimated mean AACF number in the whole organ and the calculated average AACF number per unit area were found to be statistically significant compared to the azaserine control group (AzCont) (p < 0.05). According to the results of our study, it has been shown that atypical acinar cell foci (AACF) formed in the exocrine pancreas of rats with azaserine can be reduced by a diet containing resveratrol. It was determined that the tumor burden decreased statistically significantly (p ≤ 0.05) in resveratrol‐treated rats. Accordingly, it is thought that the inhibitory effects of resveratrol may contribute to studies that reduce the occurrence of pancreatic cancer. [ABSTRACT FROM AUTHOR]

AbstractThe study aimed to assess the toxic effect of cadmium (Cd) on the exocrine and endocrine functions of pancreas, the changes in pancreatic tissue after Cd withdrawal, and the protective effects of vitamin C (VC) and Nigella sativa (NS) against Cd-induced damage. Rats were assigned to: control, Cd-treated (0.5 mg/kg/d intraperitoneal [IP] injection), VC and Cd-treated (receiving 100 mg/kg/d VC orally and Cd concomitantly), NS and Cd-treated (receiving 20 mg/kg/d NS and Cd, simultaneously), and Cd withdrawal (receiving Cd for 30 d then living free for recovery for other 30 d). Blood samples were collected and post-sacrifice pancreatic specimens were processed for light and electron microscope study. Quantitative analyses of pancreatic collagen area%, pancreatic islet parameters, β cell density, and insulin immunoexpression were done. Fasting blood glucose was significantly increased in Cd-treated and Cd-withdrawal groups, while co-treatment with VC and NS caused significant reductions (p < 0.05). Cd-induced extensive degenerative changes in pancreatic acini and islets at light and ultrastructure levels. Obvious fibrosis and congestion of blood vessels were noticed. Significant reductions in pancreatic islet number, volume, and surface area and diminished beta cell count and insulin immunoexpression were observed. After withdrawal of Cd, the whole pancreatic tissue still showed a serious impact. Concomitant treatment with VC or NS obviously reduced these degenerative changes and significantly improved pancreatic islet parameters and insulin immunoexpression. VC showed a better amendment than NS, but this difference was statistically insignificant. Therefore, VC and NS could be used as prophylactic agents that lessen Cd consequences on the pancreas. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine the morphological and morphometric features of structural changes in the components of the exocrine part of the pancreas of male rats after withdrawal of the food additive sodium glutamate and their transfer to a normal diet. Materials and methods. 4 series of experiments were conducted. The 1st series – male rats were given 70 mg/kg of sodium glutamate daily for 8 weeks to enhance their taste; the 2nd series – rats were transferred to a standard diet 8 weeks after the use of monosodium glutamate and withdrawn from the experiment after 8 weeks (at week 16); the 3rd series – control group rats up to 8 weeks, the 4th series – control rats up to 16 weeks of the experiment. The pancreas was examined morphologically with morphometric analysis after the rats were withdrawn from the experiment, the material was paraffin-embedded and sections were made, stained with hematoxylin and eosin and azan. Results. In the 1st and 2nd series of the experiment, atrophic and degenerative changes of the acini were preserved, which were discomposed due to edema of the organ, and had small sizes. Connective tissue and areas of adipose tissue, diffuse and focal infiltrates were visualized between the lobules and around the lobular ducts. The ducts were dilated. As in the 1st series, there was edema of the organ parenchyma, vessel walls and ducts with fluid leakage into the intercalated spaces, and exocrinocyte apoptosis. The morphometric study of the exocrine part of the pancreas revealed that the average size of acini was statistically significantly reduced in the 1st and 2nd experimental series by 1.4 and 1.6 times, and the area by 1.2 and 1.5 times compared to control animals of the 3rd and 4th series. In the 1st and 2nd series, acini ranging in size from 71 μm to 90 μm prevailed, accounting for 38 % and 34 %, respectively, in the 1st and 2nd control series – 91–100 μm (46 % and 42 %) and from 111 μm to 149 μm (36 % and 38 %), respectively. In the study of the number of cells in acini in the 1st series, exocrinocytes were present in the amount of 5.52 ± 0.58 vs. control 8.05 ± 0.32 (p < 0.001), in the 2nd series – 5.24 ± 0.47 vs. control 7.33 ± 0.43 (p < 0.001) The area of exocrinocytes in the 2nd series 61.95 ± 1.91 μm2 vs. 78.99 ± 0.98 μm2 (p < 0.05) were reduced. The diameter of the insertional, intra-lobular and inter-lobular ducts was enlarged. Conclusions. After 8 weeks of feeding rats with monosodium glutamate and after its withdrawal and transfer of rats to the standard diet of the rat vivarium in the next 8 weeks, no improvement in the state of the pancreas was recorded, which was confirmed by morphological and morphometric studies.

Acute pancreatitis (AP) entails pancreatic inflammation, tissue damage and dysregulated enzyme secretion, including pancreatic lipase (PL). The role of irisin, an anti-inflammatory and anti-apoptotic cytokine, in AP and exocrine pancreatic stress is unclear. We have previously shown that irisin regulates PL through the PPARγ-PGC1α-FNDC5 pathway. In this study, we investigated irisin and irisin's pathway on AP in in vitro (AR42J-B13) and ex vivo (rat primary acinar) models using molecular, biochemical and immunohistochemistry methodology. Pancreatitis induction (cerulein (cer)) resulted in a significant up-regulation of the PPARγ-PGC1α-FNDC5 axis, PL expression and secretion and endoplasmic reticulum (ER) stress unfolded protein response (UPR) signal-transduction markers (CHOP, XBP-1 and ATF6). Irisin addition in the cer-pancreatitis state resulted in a significant down-regulation of the PPARγ-PGC1α-FNDC5 axis, PPARγ nucleus-translocation and inflammatory state (TNFα and IL-6) in parallel to diminished PL expression and secretion (in vitro and ex vivo models). Irisin addition up-regulated the expression of pro-survival UPR markers (ATF6 and XBP-1) and reduced UPR pro-apoptotic markers (CHOP) under cer-pancreatitis and induced ER stress (tunicamycin), consequently increasing cells viability. Irisin's pro-survival effect under cer-pancreatitis state was abolished under PPARγ inhibition. Our findings suggest irisin as a potential therapeutic option for AP via its ability to up-regulate pro-survival UPR signals and activate the PPARγ-PGC1α-FNDC5 pathway. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine the morphological and morphometric features of structural changes in the components of the exocrine part of the pancreas of male rats after withdrawal of the food additive sodium glutamate and their transfer to a normal diet. Materials and methods. 4 series of experiments were conducted. The 1st series – male rats were given 70 mg/kg of sodium glutamate daily for 8 weeks to enhance their taste; the 2nd series – rats were transferred to a standard diet 8 weeks after the use of monosodium glutamate and withdrawn from the experiment after 8 weeks (at week 16); the 3rd series – control group rats up to 8 weeks, the 4th series – control rats up to 16 weeks of the experiment. The pancreas was examined morphologically with morphometric analysis after the rats were withdrawn from the experiment, the material was paraffin-embedded and sections were made, stained with hematoxylin and eosin and azan. Results. In the 1st and 2nd series of the experiment, atrophic and degenerative changes of the acini were preserved, which were discomposed due to edema of the organ, and had small sizes. Connective tissue and areas of adipose tissue, diffuse and focal infiltrates were visualized between the lobules and around the lobular ducts. The ducts were dilated. As in the 1st series, there was edema of the organ parenchyma, vessel walls and ducts with fluid leakage into the intercalated spaces, and exocrinocyte apoptosis. The morphometric study of the exocrine part of the pancreas revealed that the average size of acini was statistically significantly reduced in the 1st and 2nd experimental series by 1.4 and 1.6 times, and the area by 1.2 and 1.5 times compared to control animals of the 3rd and 4th series. In the 1st and 2nd series, acini ranging in size from 71 μm to 90 μm prevailed, accounting for 38 % and 34 %, respectively, in the 1st and 2nd control series – 91–100 μm (46 % and 42 %) and from 111 μm to 149 μm (36 % and 38 %), respectively. In the study of the number of cells in acini in the 1st series, exocrinocytes were present in the amount of 5.52 ± 0.58 vs. control 8.05 ± 0.32 (p < 0.001), in the 2nd series – 5.24 ± 0.47 vs. control 7.33 ± 0.43 (p < 0.001) The area of exocrinocytes in the 2nd series 61.95 ± 1.91 μm2 vs. 78.99 ± 0.98 μm2 (p < 0.05) were reduced. The diameter of the insertional, intra-lobular and inter-lobular ducts was enlarged. Conclusions. After 8 weeks of feeding rats with monosodium glutamate and after its withdrawal and transfer of rats to the standard diet of the rat vivarium in the next 8 weeks, no improvement in the state of the pancreas was recorded, which was confirmed by morphological and morphometric studies. [ABSTRACT FROM AUTHOR]

An increase in intracellular [Ca2+] in exocrine acinar cells resident in the salivary glands or pancreas is a fundamental event that drives fluid secretion and exocytosis of proteins. Stimulation with secretagogues initiates Ca2+ signals with precise spatiotemporal properties thought to be important for driving physiological output. Both in vitro, in acutely isolated acini, and in vivo, in animals expressing genetically encoded indicators, individual cells appear specialized to initiate Ca2+ signals upon stimulation. Furthermore, these signals appear to spread to neighbouring cells. These properties are present in the absence of a conventional pacemaker mechanism dependent on the cyclical activation of Ca2+‐dependent or Ca2+‐conducting plasma membrane ion channels. In this article, we propose a model for ‘pacing’ intracellular Ca2+ signals in acinar cells based on the enhanced sensitivity of a subpopulation of individual cells and the intercellular diffusion through gap junctions of inositol 1,4,5‐trisphosphate and Ca2+ to neighbouring cells. [ABSTRACT FROM AUTHOR]

Acute pancreatitis (AP) entails pancreatic inflammation, tissue damage and dysregulated enzyme secretion, including pancreatic lipase (PL). The role of irisin, an anti-inflammatory and anti-apoptotic cytokine, in AP and exocrine pancreatic stress is unclear. We have previously shown that irisin regulates PL through the PPARγ-PGC1α-FNDC5 pathway. In this study, we investigated irisin and irisin’s pathway on AP in in vitro (AR42J-B13) and ex vivo (rat primary acinar) models using molecular, biochemical and immunohistochemistry methodology. Pancreatitis induction (cerulein (cer)) resulted in a significant up-regulation of the PPARγ-PGC1α-FNDC5 axis, PL expression and secretion and endoplasmic reticulum (ER) stress unfolded protein response (UPR) signal-transduction markers (CHOP, XBP-1 and ATF6). Irisin addition in the cer-pancreatitis state resulted in a significant down-regulation of the PPARγ-PGC1α-FNDC5 axis, PPARγ nucleus-translocation and inflammatory state (TNFα and IL-6) in parallel to diminished PL expression and secretion (in vitro and ex vivo models). Irisin addition up-regulated the expression of pro-survival UPR markers (ATF6 and XBP-1) and reduced UPR pro-apoptotic markers (CHOP) under cer-pancreatitis and induced ER stress (tunicamycin), consequently increasing cells viability. Irisin’s pro-survival effect under cer-pancreatitis state was abolished under PPARγ inhibition. Our findings suggest irisin as a potential therapeutic option for AP via its ability to up-regulate pro-survival UPR signals and activate the PPARγ-PGC1α-FNDC5 pathway.

Objectives: Imaging features of pancreatic acinar cystic transformation (ACT) have been published. We aimed to describe the clinical and radiological characteristics of patients with a presumed pancreatic ACT diagnosis, reappraising the value of these published imaging criteria.Single-center retrospective study (2003–2021) of consecutive patients with a presumed diagnosis of ACT as suggested by the local expert multidisciplinary case review board. Patients without available imaging (CT or MRI) for review were excluded. Patients were classified into “certain” ACT (if ≥ 2 imaging criteria and no differential diagnosis) or “uncertain” ACT (if ≥ 1 imaging criteria and suggested differential diagnoses).Sixty-four patients (35 males, [55%]) were included. ACT was considered “certain” for 34 patients (53%) and “uncertain” for 30 patients (47%). The number of ACT criteria did not differ between groups, with 91.2% of patients with ≥ 3 ACT imaging criteria in the “certain” group vs 93.3% in the “uncertain” group (p = 0.88). In the “uncertain” group, the main suggested differentials were branch-duct intraductal papillary mucinous neoplasm (18/30 patients, 60%), calcifying chronic pancreatitis (8/30 patients, 27%), both (three patients, 10%) and serous cystadenoma (one patient, 3%). Calcifications were significantly more frequent in the “uncertain” group (89% vs 63% in the “certain” group, p = 0.02).Published ACT imaging criteria are frequently associated with features suggesting differential diagnoses. They appear insufficient to reach a final diagnosis in a subset of patients.ACT displays a heterogeneous morphological imaging presentation challenging the non-invasive diagnostic work-up. Physicians’ and radiologists’ awareness of this entity is important to better understand its natural history and improve non-invasive diagnostic criteria.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.Materials and methods: Imaging features of pancreatic acinar cystic transformation (ACT) have been published. We aimed to describe the clinical and radiological characteristics of patients with a presumed pancreatic ACT diagnosis, reappraising the value of these published imaging criteria.Single-center retrospective study (2003–2021) of consecutive patients with a presumed diagnosis of ACT as suggested by the local expert multidisciplinary case review board. Patients without available imaging (CT or MRI) for review were excluded. Patients were classified into “certain” ACT (if ≥ 2 imaging criteria and no differential diagnosis) or “uncertain” ACT (if ≥ 1 imaging criteria and suggested differential diagnoses).Sixty-four patients (35 males, [55%]) were included. ACT was considered “certain” for 34 patients (53%) and “uncertain” for 30 patients (47%). The number of ACT criteria did not differ between groups, with 91.2% of patients with ≥ 3 ACT imaging criteria in the “certain” group vs 93.3% in the “uncertain” group (p = 0.88). In the “uncertain” group, the main suggested differentials were branch-duct intraductal papillary mucinous neoplasm (18/30 patients, 60%), calcifying chronic pancreatitis (8/30 patients, 27%), both (three patients, 10%) and serous cystadenoma (one patient, 3%). Calcifications were significantly more frequent in the “uncertain” group (89% vs 63% in the “certain” group, p = 0.02).Published ACT imaging criteria are frequently associated with features suggesting differential diagnoses. They appear insufficient to reach a final diagnosis in a subset of patients.ACT displays a heterogeneous morphological imaging presentation challenging the non-invasive diagnostic work-up. Physicians’ and radiologists’ awareness of this entity is important to better understand its natural history and improve non-invasive diagnostic criteria.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.Results: Imaging features of pancreatic acinar cystic transformation (ACT) have been published. We aimed to describe the clinical and radiological characteristics of patients with a presumed pancreatic ACT diagnosis, reappraising the value of these published imaging criteria.Single-center retrospective study (2003–2021) of consecutive patients with a presumed diagnosis of ACT as suggested by the local expert multidisciplinary case review board. Patients without available imaging (CT or MRI) for review were excluded. Patients were classified into “certain” ACT (if ≥ 2 imaging criteria and no differential diagnosis) or “uncertain” ACT (if ≥ 1 imaging criteria and suggested differential diagnoses).Sixty-four patients (35 males, [55%]) were included. ACT was considered “certain” for 34 patients (53%) and “uncertain” for 30 patients (47%). The number of ACT criteria did not differ between groups, with 91.2% of patients with ≥ 3 ACT imaging criteria in the “certain” group vs 93.3% in the “uncertain” group (p = 0.88). In the “uncertain” group, the main suggested differentials were branch-duct intraductal papillary mucinous neoplasm (18/30 patients, 60%), calcifying chronic pancreatitis (8/30 patients, 27%), both (three patients, 10%) and serous cystadenoma (one patient, 3%). Calcifications were significantly more frequent in the “uncertain” group (89% vs 63% in the “certain” group, p = 0.02).Published ACT imaging criteria are frequently associated with features suggesting differential diagnoses. They appear insufficient to reach a final diagnosis in a subset of patients.ACT displays a heterogeneous morphological imaging presentation challenging the non-invasive diagnostic work-up. Physicians’ and radiologists’ awareness of this entity is important to better understand its natural history and improve non-invasive diagnostic criteria.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.Conclusion: Imaging features of pancreatic acinar cystic transformation (ACT) have been published. We aimed to describe the clinical and radiological characteristics of patients with a presumed pancreatic ACT diagnosis, reappraising the value of these published imaging criteria.Single-center retrospective study (2003–2021) of consecutive patients with a presumed diagnosis of ACT as suggested by the local expert multidisciplinary case review board. Patients without available imaging (CT or MRI) for review were excluded. Patients were classified into “certain” ACT (if ≥ 2 imaging criteria and no differential diagnosis) or “uncertain” ACT (if ≥ 1 imaging criteria and suggested differential diagnoses).Sixty-four patients (35 males, [55%]) were included. ACT was considered “certain” for 34 patients (53%) and “uncertain” for 30 patients (47%). The number of ACT criteria did not differ between groups, with 91.2% of patients with ≥ 3 ACT imaging criteria in the “certain” group vs 93.3% in the “uncertain” group (p = 0.88). In the “uncertain” group, the main suggested differentials were branch-duct intraductal papillary mucinous neoplasm (18/30 patients, 60%), calcifying chronic pancreatitis (8/30 patients, 27%), both (three patients, 10%) and serous cystadenoma (one patient, 3%). Calcifications were significantly more frequent in the “uncertain” group (89% vs 63% in the “certain” group, p = 0.02).Published ACT imaging criteria are frequently associated with features suggesting differential diagnoses. They appear insufficient to reach a final diagnosis in a subset of patients.ACT displays a heterogeneous morphological imaging presentation challenging the non-invasive diagnostic work-up. Physicians’ and radiologists’ awareness of this entity is important to better understand its natural history and improve non-invasive diagnostic criteria.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.Clinical relevance statement: Imaging features of pancreatic acinar cystic transformation (ACT) have been published. We aimed to describe the clinical and radiological characteristics of patients with a presumed pancreatic ACT diagnosis, reappraising the value of these published imaging criteria.Single-center retrospective study (2003–2021) of consecutive patients with a presumed diagnosis of ACT as suggested by the local expert multidisciplinary case review board. Patients without available imaging (CT or MRI) for review were excluded. Patients were classified into “certain” ACT (if ≥ 2 imaging criteria and no differential diagnosis) or “uncertain” ACT (if ≥ 1 imaging criteria and suggested differential diagnoses).Sixty-four patients (35 males, [55%]) were included. ACT was considered “certain” for 34 patients (53%) and “uncertain” for 30 patients (47%). The number of ACT criteria did not differ between groups, with 91.2% of patients with ≥ 3 ACT imaging criteria in the “certain” group vs 93.3% in the “uncertain” group (p = 0.88). In the “uncertain” group, the main suggested differentials were branch-duct intraductal papillary mucinous neoplasm (18/30 patients, 60%), calcifying chronic pancreatitis (8/30 patients, 27%), both (three patients, 10%) and serous cystadenoma (one patient, 3%). Calcifications were significantly more frequent in the “uncertain” group (89% vs 63% in the “certain” group, p = 0.02).Published ACT imaging criteria are frequently associated with features suggesting differential diagnoses. They appear insufficient to reach a final diagnosis in a subset of patients.ACT displays a heterogeneous morphological imaging presentation challenging the non-invasive diagnostic work-up. Physicians’ and radiologists’ awareness of this entity is important to better understand its natural history and improve non-invasive diagnostic criteria.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.Key Points: Imaging features of pancreatic acinar cystic transformation (ACT) have been published. We aimed to describe the clinical and radiological characteristics of patients with a presumed pancreatic ACT diagnosis, reappraising the value of these published imaging criteria.Single-center retrospective study (2003–2021) of consecutive patients with a presumed diagnosis of ACT as suggested by the local expert multidisciplinary case review board. Patients without available imaging (CT or MRI) for review were excluded. Patients were classified into “certain” ACT (if ≥ 2 imaging criteria and no differential diagnosis) or “uncertain” ACT (if ≥ 1 imaging criteria and suggested differential diagnoses).Sixty-four patients (35 males, [55%]) were included. ACT was considered “certain” for 34 patients (53%) and “uncertain” for 30 patients (47%). The number of ACT criteria did not differ between groups, with 91.2% of patients with ≥ 3 ACT imaging criteria in the “certain” group vs 93.3% in the “uncertain” group (p = 0.88). In the “uncertain” group, the main suggested differentials were branch-duct intraductal papillary mucinous neoplasm (18/30 patients, 60%), calcifying chronic pancreatitis (8/30 patients, 27%), both (three patients, 10%) and serous cystadenoma (one patient, 3%). Calcifications were significantly more frequent in the “uncertain” group (89% vs 63% in the “certain” group, p = 0.02).Published ACT imaging criteria are frequently associated with features suggesting differential diagnoses. They appear insufficient to reach a final diagnosis in a subset of patients.ACT displays a heterogeneous morphological imaging presentation challenging the non-invasive diagnostic work-up. Physicians’ and radiologists’ awareness of this entity is important to better understand its natural history and improve non-invasive diagnostic criteria.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis.The criteria to help diagnose ACT are frequently associated with features suggestive of differentials.The main alternatives suggested when ACT diagnosis was “uncertain” were branch-duct intraductal papillary mucinous neoplasm and calcifying chronic pancreatitis.Published ACT diagnostic imaging criteria can be insufficient for a definite non-invasive diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Recent associative studies have linked intra-pancreatic fat deposition (IPFD) with risk of pancreatitis, but the causal relationship remains unclear., Methods: Utilizing Mendelian randomization, we evaluated the causal association between genetically predicted IPFD and pancreatitis. This approach utilized genetic variants from genome-wide association studies of IPFD (n=25,617), acute pancreatitis (n=6,787 cases/361,641 controls), and chronic pancreatitis (n=3,875 cases/361,641 controls)., Results: Genetically predicted IPFD was significantly associated with acute pancreatitis (OR per 1-SD increase: 1.40[95%CI:1.12-1.76], p=0.0032) and chronic pancreatitis (OR:1.64[95%CI:1.13-2.39], p=0.0097)., Discussion: Our findings support a causal role of IPFD in pancreatitis, suggesting that reducing IPFD could lower the risk of pancreatitis., Competing Interests: Conflict of interest: Outside of the current work, MH reports research grants from Boehringer Ingelheim and Sanofi to the University Hospital of Tübingen, participation in advisory board for Boehringer Ingelheim, Sanofi, and Amryt, and lecture fees from Amryt, AstraZeneca, Bayer, Boehringer Ingelheim, Eli Lilly, Novartis, Novo Nordisk, and Sanofi. L.W. provided consulting service to Pupil Bio, Inc. and reviewed manuscripts for Gastroenterology Report, and received honorarium.

Background: Atypical acinar cell foci (AACF) seen in pancreatic cancer are fatal and have been studied with some causative agents. However, for the first time, the effect of acetylsalicylic acid with nitric oxide (NO-ASA) on AACF was examined in this study. Although NO-ASA has very successful inhibitory effects against some types of cancer, it has not been investigated whether they can exert their inhibition effects on AACFs., Methods: For experimental purposes, 21 14-day-old male Wistar albino rats were used. Azaserine (30 mg/kg) was dissolved in 0.9% NaCl solution and injected intraperitoneally (i.p.) into 14 rats, except for the Control group (Cont) rats, for three weeks. Rats that were injected with azaserine once a week for three weeks and those that did not receive treatment were divided into experimental groups. 15 days after the end of the azaserine injection protocol, NO-ASA was applied to azaserine with NO-ASA (Az+NO-ASA) group rats three consecutive times with an interval of 15 days by gavage. At the end of the 5-month period, pancreatic tissue was dissected and weighed. Pancreas preparations prepared from histological sections were examined for AACF burden and analyzed via a video image analyzer. One-way analysis of variance (ANOVA) non-parametric statistical analyses were performed to test whether there was a difference between the averages of the experimental and Control groups., Results: AACF burden in both groups injected with azaserine was found to be statistically significant in all categories compared to that of the Control group ( p < 0.05). The average Calculated Estimated average AACF volume (mm 3 ) values, the Calculated estimated average AACF diameter (μm), the Estimated average number of AACF per unit volume, AACF rate as a % of Calculated Organ Volume were higher in the AzCont group rats than in the Az+NO-ASA group, when compared, and there was an important level statistical difference between the groups ( p < 0.05). It was determined that for all parameters AACFs load in Az+NO-ASA group rats were significantly reduced compared to that of AzCont group rats ( p < 0.05)., Conclusions: We observed that, as a result of the NO-ASA application, the experimental AACF focus ratio created by azaserine injection was significantly inhibited. The inhibitory effect of AACFs in Az+NO-ASA group rats may have resulted from the significant and independent chemopreventive and/or chemotherapeutic activity of NO-ASA against exocrine pancreatic AACF foci.

Background The pre-malignant tendency of the normal, non-affected portion of the pancreas is not as well explored as the multicentricity documented in pancreatic cancer cases. In order to ascertain the expression of inflammatory markers and Erythroblastic Oncogene B ( ErbB2 ) in the non-affected pancreas in patients with pancreatic cancer, a case-control study was carried out. Materials and methods In patients who underwent pancreatoduodenectomy for pancreatic cancer (PC), pro-inflammatory genes and a tumor marker, erythroblastic oncogene 2 ( ErbB2 ) in the epidermal growth factor receptor family were analyzed in the pancreatic tissue at the cut surface of the normal pancreas using qRT-PCR. Twenty patients diagnosed with Chronic pancreatitis (CP) after Frey's surgical procedure were selected, and their pancreatic tissues were analyzed as controls. The HPLC-purified primers were designed using National Center for Biotechnology Information (NCBI) software. The primer's specificity was verified for gene expression analysis using the Basic Local Alignment Search Tool (BLAST). The genes under study were normalized using β-actin as the housekeeping gene, and the 2 -ddct method was used to compute the fold change compared to the control sample. Results Patients with margin-positive were not included. Pro-inflammatory genes ( TNF-α, NF-kβ,  and  COX-2 ) had significantly lower foldchange in PC patients compared to the CP group. The CP control group had higher levels of  IL-6  gene expression than the PC group. Patients with pancreatic cancer had a considerably higher expression of the  ErbB2  gene than patients with CP. Conclusion The upregulated  ErbB2  gene in the unaffected pancreatic tissue of pancreatic cancer patients, when compared to controls, indicates that the remaining pancreas may have the capacity to cause cancer. Proto-oncogene may play a role in the pathophysiologic process in patients with pancreatic cancer., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Mohanan et al.)