Tetsuya Seki

A case of autoimmune pancreatitis responding to steroid therapy

We report a case of autoimmune pancreatitis without obvious evidence of autoimmunological participation, which responded well to steroid treatment and provided histologic and radiographic evidence for this improvement. A 68-year-old woman presented abdominal fullness, diffuse pancreatic swelling on abdominal computed tomography and ultrasonography, and diffuse narrowing of the main pancreatic duct on endoscopic retrograde pancreatography. Transgastric aspiration needle biopsy of the body of the pancreas performed under endoscopic ultrasonography showed severe atrophy of acinar cells, infiltration of T lymphocytes. She was diagnosed as having autoimmune pancreatitis without obvious evidence of autoimmunological participation. Administration of 30 mg/day of predonisolone was started. Computed tomography showed marked improvement of the diffuse swelling of the pancreas, and endoscopic retrograde pancreatograpy showed amelioration of the narrowing of the main pancreatic duct after the start of treatment. Pancreatic tissue obtained by needle biopsy after the start of treatment with predonisolone revealed marked histologic improvement, including amelioration of the fibrosis, and infiltration of inflammatory lymphocytes, and a substantial increase in the number of pancreatic acinar cells. The present report is the first to demonstrate histologic recovery of autoimmune pancreatitis after steroid therapy.

Seroprevalence of immunoglobulin G antibodies against Helicobacter pylori among endoscopy personnel in Japan.

BACKGROUND The seroprevalence of immunoglobulin G antibodies against Helicobacter pylori in endoscopy personnel was determined to investigate whether gastrointestinal endoscopists and endoscopy nurses in Japan are at an increased risk for H. pylori infection and to clarify risk factors for H. pylori infection during endoscopy. METHODS One hundred twenty-one gastrointestinal endoscopists and endoscopy nurses provided personal information, including their observance of infection-control measures, by means of self-administered questionnaire. One hundred one age-matched healthy individuals undergoing routine physical examinations served as controls. Serum samples from each subject were examined with enzyme-linked immunosorbent assay for the presence of IgG antibodies against H. pylori. RESULTS Among younger subjects (< 40 years old), endoscopists and endoscopy nurses had higher seropositive rates than did control subjects (p < 0.05). Among older subjects (> or = 40 years old), the seropositive rate did not differ between endoscopy personnel and control subjects (p = 0.2174). However, among older seropositive subjects, endoscopy personnel had significantly higher antibody titers than did control subjects (p < 0.01). Older seropositive endoscopists performed significantly more examinations per month than did their seronegative colleagues (p < 0.05). Furthermore, younger seropositive endoscopy nurses performed significantly more examinations per month than did seronegative nurses (p < 0.05). CONCLUSIONS Gastrointestinal endoscopists and endoscopy nurses in Japan are at high risk for H. pylori infection. The risk of H. pylori infection is correlated with the frequency of endoscopic examinations, especially in older gastrointestinal endoscopists and younger endoscopy nurses.

A case of autoimmune pancreatitis complicated with immune thrombocytopenia during maintenance therapy with prednisolone.

A unique form of chronic pancreatitis, primary inflammatory sclerosis of the pancreas, which may result from an autoimmune mechanism, was first reported by Sarles et al (1). Since then, several authors have reported similar cases, and Yoshida et al (2) first proposed the concept of autoimmune pancreatitis. One of the characteristics of so-called autoimmune pancreatitis is an occasional association with other autoimmune diseases such as Sj ̈ ogren’s syndrome (3), primary biliary cirrhosis (4), and primary sclerosing cholangitis (4, 5). However, autoimmune pancreatitis rarely associates with immune thrombocytopenia, and only one case has been previously reported in the Japanese literature (6). According to this report, autoimmune pancreatitis and immune thrombocytopenia occurred concomitantly. We report a case complicated with immune thrombocytopenia during maintenance therapy with prednisolone for autoimmune pancreatitis. In our case, elevation of serum level of total immunoglobulin (Ig) G was thought to be suggestive of the development of other autoimmune disease, and the determination of IgG subclass would provide a useful tool to differentiate exacerbation of autoimmune pancreatitis from the development of other autoimmune disease.

Hepatocyte growth factor stimulates cell growth and enhances the expression of transforming growth factor α mRNA in AsPC-1 human pancreatic cancer cells

Abstract: We investigated the effects of hepatocyte growth factor (HGF) and transforming growth factor α (TGF α) on cell growth in four human pancreatic cancer cell lines. Changes in the expression of mRNAs of HGF, c-met, TGF α, and epidermal growth factor receptor (EGFR) by treatment with HGF and TGF α were observed. Cell growth with growth factors was assessed with the MTT assay and compared with basal growth without growth factors. Although HGF stimulated cell growth in AsPC-1, COLO-357, and T3M4 cells, Panc-1 cells showed no response to HGF. TGF α stimulated the growth of all the above cells. The expression of c-met mRNA under nonstimulated conditions was detected with Northern blotting in all cells. Treatment with HGF slightly enhanced the expression of c-met mRNA only in COLO-357 cells. The intensity of EGFR expression was consistent, and HGF mRNA was not detected during induction experiments in any cell type. Concomitant treatment with HGF and TGF α exerted an effect that was additive or less on the growth of all cells. Expression of TGF α was enhanced by HGF treatment only in AsPC-1 cells. These results suggested that HGF and TGF α stimulated cell growth through a final common pathway of signal transduction.