Pancreatology最新文献

{"title":"Water avoidance stress exacerbates orthotopic pancreatic cancer growth by suppressing cytotoxic T lymphocyte infiltration","authors":"Shin Nishii ,&nbsp;Yoshikiyo Okada ,&nbsp;Akinori Mizoguchi ,&nbsp;Nao Sugihara ,&nbsp;Hiroyuki Nishimura ,&nbsp;Kana Ayaki ,&nbsp;Yuta Yoshidome ,&nbsp;Hiroyuki Tahara ,&nbsp;Tomoaki Horiuchi ,&nbsp;Shun Takahashi ,&nbsp;Dai Hirata ,&nbsp;Chie Kurihara ,&nbsp;Kazuyuki Narimatsu ,&nbsp;Shunsuke Komoto ,&nbsp;Kengo Tomita ,&nbsp;Fumiho Asai ,&nbsp;Minori Koga ,&nbsp;Yuji Morimoto ,&nbsp;Hiroyuki Imaeda ,&nbsp;Yoshikazu Tsuzuki ,&nbsp;Ryota Hokari","doi":"10.1016/j.pan.2025.08.003","DOIUrl":"10.1016/j.pan.2025.08.003","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>The incidence of pancreatic cancer is increasing, and it has a poor prognosis. Also, it is often refractory to standard chemotherapy. Psychological stress influences the development of some malignant neoplasms; however, its immunological mechanism is unclear. In this study, we investigated whether water avoidance stress (WAS) promotes mouse orthotopic pancreatic cancer growth and the mechanism through which WAS influences anticancer immunological responses.</div></div><div><h3>Methods</h3><div>Mouse pancreatic adenocarcinoma cells were orthotopically inoculated into the pancreas of mice. After 2 weeks, the mice were assigned to receive either WAS or sham. After 6 weeks of tumor inoculation, the tumor volume was calculated. The peritumoral interferon-gamma (IFN-γ) and tumor necrosis factor-alpha (TNF-α) were measured; lymphocytes in the pancreas were isolated and analyzed. CD4⁺ and CD8⁺ T lymphocyte peritumoral infiltration and intercellular adhesion molecule 1 (ICAM-1) expression were analyzed. Tumor-bearing mice were subjected to either WAS or control; the number of adhesive lymphocytes was calculated.</div></div><div><h3>Results</h3><div>WAS promoted pancreatic cancer growth, and suppressed peritumoral IFN-γ mRNA expression, and cytotoxic T lymphocyte peritumoral infiltration. WAS also suppressed peritumoral lymphocyte adhesion, ICAM-1 expression in the vascular endothelium in the peritumoral region, and peritumoral TNF-α mRNA expression.</div></div><div><h3>Conclusion</h3><div>Our results suggest that in the peritumoral region, WAS suppressed anticancer immunological responses by the suppression of TNF-α secretion, ICAM-1 expression, lymphocyte adhesion, cytotoxic T lymphocyte infiltration, and IFN-γ secretion, thereby promoted pancreatic cancer growth. Inducing the upregulation of adhesion molecules and augmentation of cytotoxic T cell recruitment may lead to the development of new treatments for pancreatic cancer.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 6","pages":"Pages 919-929"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of liposomal irinotecan (nal-IRI) combined with 5-fluorouracil and leucovorin in second or subsequent lines for metastatic pancreatic cancer in Italy. It can be done","authors":"Jacopo Giuliani ,&nbsp;Daniela Mangiola ,&nbsp;Giuseppe Napoli ,&nbsp;Silvia Muraro ,&nbsp;Marina Tommasi ,&nbsp;Francesco Fiorica ,&nbsp;Teodoro Sava","doi":"10.1016/j.pan.2025.08.007","DOIUrl":"10.1016/j.pan.2025.08.007","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 6","pages":"Pages 983-985"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on 'Why is the rectal route for NSAIDs favorable for preventing post-ERCP pancreatitis?'","authors":"Hao Lin, Lianyi Bao","doi":"10.1016/j.pan.2025.08.018","DOIUrl":"https://doi.org/10.1016/j.pan.2025.08.018","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Association of Pancreatology Revised Guidelines on Acute Pancreatitis 2025: Supported and Endorsed by the American Pancreatic Association, European Pancreatic Club, Indian Pancreas Club, and Japan Pancreas Society","authors":"IAP/APA/EPC/IPC/JPS Working Group","doi":"10.1016/j.pan.2025.04.020","DOIUrl":"10.1016/j.pan.2025.04.020","url":null,"abstract":"<div><h3>Introduction</h3><div>The International Association of Pancreatology, alongside the American Pancreatic Association, the European Pancreatic Club, the Indian Pancreas Club, and the Japan Pancreas Society, decided to update its earlier guidelines for the management of acute pancreatitis (AP) given the remarkable advances in our understanding of AP and its management over the last decade.</div></div><div><h3>Methods</h3><div>These organizations put together a group of international experts to address important issues related to the management of AP. Guideline Development Groups comprising international domain experts framed clinically relevant questions and conducted thorough literature searches and systematic reviews to address the questions. Questions were framed in the PICO (Participant, Intervention, Comparator, and Outcome) format where appropriate. The evidence from the literature was synthesized to develop evidence-based recommendations for each question. The quality of evidence and the strength of the recommendations were graded according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). For some questions, we have provided Good Practice Statements if enough direct evidence was unavailable.</div></div><div><h3>Results</h3><div>The guidelines pertain to 18 domains comprising 96 questions. The recommendations cover almost all aspects of managing AP, including pain control, fluid therapy, patient stabilization, nutritional support, conservative and interventional treatment for infected necrotizing pancreatitis, management of complications, discharge criteria, guidance on follow-up, and strategies for prevention of recurrence. Specific types of AP, such as those associated with pregnancy, trauma, and metabolic factors have been given special attention.</div></div><div><h3>Conclusion</h3><div>The recommendations presented here should serve as an evidence-based resource for practicing physicians and caregivers to treat patients with AP more effectively. In addition, the guidelines identify areas for future research, mainly targeted therapies for controlling systemic inflammation and mitigating organ dysfunction.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 6","pages":"Pages 770-814"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144619721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of early and delayed intervention for symptomatic acute necrotizing pancreatitis: Need for Re-intervention and clinical outcomes","authors":"Pankaj Singh ,&nbsp;Vikas Singla ,&nbsp;Muzaffer Rashid Shawl ,&nbsp;Akash Goel ,&nbsp;Kaushal Madan ,&nbsp;Pankaj Gupta ,&nbsp;Pallavi Garg ,&nbsp;Vivek Saxena ,&nbsp;Amit Kumar","doi":"10.1016/j.pan.2025.07.004","DOIUrl":"10.1016/j.pan.2025.07.004","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 6","pages":"Pages 974-976"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TSH as a novel biomarker for recurrence of hypertriglyceridemia pancreatitis: a clinical predictive tool linking lipid dysregulation to inflammation","authors":"Bang Shao ,&nbsp;Baohui Hong ,&nbsp;Qiuyun Gu ,&nbsp;Chunlan Huang ,&nbsp;Yue Zeng ,&nbsp;Qixiang Mei ,&nbsp;Junjie Fan","doi":"10.1016/j.pan.2025.07.417","DOIUrl":"10.1016/j.pan.2025.07.417","url":null,"abstract":"<div><h3>Backgrounds</h3><div>With the change in dietary patterns, the number of patients suffering from hypertriglyceridemia-induced acute pancreatitis (HTG-AP) has been increasing year by year. HTG-AP patients have a higher likelihood of progressing to severe conditions and exhibit a markedly increased risk of recurrence compared to other etiologies. At present, effective prediction models for the recurrence of HTG-AP need to be established and improved urgently, which is of great significance in improving the prognosis of patients.</div></div><div><h3>Methods</h3><div>A total of 429 HTG-AP patients were included in this study. Variables were selected by LASSO regression to construct a Logistic regression prediction model, and the performance of the model was verified by ROC curve, calibration curve and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>Elevated Thyroid-stimulating hormone (TSH) and triglyceride (TG) levels, Female and Age &gt;33 years were identified as independent risk factors (<em>P</em> &lt; 0.05). A further dietary retrospective study found that the intake of fat and carbohydrate in the recurrent HTG-AP (RAP) group was significantly higher than that in the primary HTG-AP (OAP) group (<em>P</em> &lt; 0.01), while the salt intake was much lower.</div></div><div><h3>Conclusion</h3><div>Elevated TSH was likely to be an independent risk factor for HTG-AP recurrence. In addition, the new nomogram model based on TSH level shows high accuracy in predicting HTG-AP recurrence, which is expected to provide certain help for clinical prevention and treatments.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 6","pages":"Pages 849-859"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between intra-tumoral microbiome and genetic alterations in intraductal papillary mucinous neoplasms of the pancreas","authors":"Kosuke Fukuda ,&nbsp;Yuto Hozaka ,&nbsp;Hideyuki Oi ,&nbsp;Miyo Tomita ,&nbsp;Tetsuya Idichi ,&nbsp;Yoichi Yamasaki ,&nbsp;Yota Kawasaki ,&nbsp;Yodai Hayashi ,&nbsp;Yuichi Goto ,&nbsp;Tsuyoshi Sugiura ,&nbsp;Toshiaki Akahane ,&nbsp;Michiyo Higashi ,&nbsp;Akihide Tanimoto ,&nbsp;Takao Ohtsuka","doi":"10.1016/j.pan.2025.08.001","DOIUrl":"10.1016/j.pan.2025.08.001","url":null,"abstract":"<div><h3>Background/objectives</h3><div>We previously demonstrated that intra-tumoral microbiome infection may affects the clinicopathological characteristics of pancreatic intraductal papillary mucinous neoplasms (IPMNs) and showed that these characteristics are also influenced by gene mutations. The aim of this study was to investigate whether specific microbiome infections lead to alterations in the expression of specific genes in IPMNs.</div></div><div><h3>Methods</h3><div>DNA was extracted from 26 resected IPMN samples and subjected to genetic mutation assessment and microbiome analysis. The relationship between intra-tumoral microbiome and genetic alterations was investigated.</div></div><div><h3>Results</h3><div>There was an increasing trend in the percentage of Firmicutes in <em>KRAS</em>- and <em>GNAS</em>-mutated IPMNs, whereas Proteobacteria tended to decrease in <em>KRAS</em>-mutated IPMNs. <em>KLF4</em>-mutated IPMNs, particularly within the <em>KRAS-</em>mutated group, had significantly low α-diversity (p &lt; 0.05). The relative abundance of Firmicutes and Proteobacteria was significantly higher in <em>KLF4</em>-mutated IPMNs, especially in <em>KLF4</em>-mutated IPMNs among the <em>KRAS</em>-mutated groups. An increased relative abundance of Firmicutes and Proteobacteria, along with the associated reduction in microbial diversity, was associated with a higher frequency of gene mutations, including KLF4.</div></div><div><h3>Conclusions</h3><div>This study suggest that the intratumoral microbiome may be linked to the genetic characteristics of IPMNs and potentially contribute to their malignant progression.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 6","pages":"Pages 905-911"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acinar cell scoring on histology of the pancreatic stump reinforces subjective texture assessment during pancreatoduodenectomy to predict post-operative pancreatic Fistula","authors":"Shoichi Irie ,&nbsp;Yoshihiro Mise ,&nbsp;Mamiko Miyashita ,&nbsp;Hirofumi Ichida ,&nbsp;Ryuji Yoshioka ,&nbsp;Hiroshi Imamura ,&nbsp;Shuko Nojiri ,&nbsp;Yuki Fukumura ,&nbsp;Akio Saiura","doi":"10.1016/j.pan.2025.07.408","DOIUrl":"10.1016/j.pan.2025.07.408","url":null,"abstract":"<div><h3>Background/objectives</h3><div>The surgical pancreatic texture (SPT), which is determined by palpation during surgery, can predict postoperative pancreatic fistulae (POPF) but is subjective. This observational study examined the accuracy and feasibility of our objective “Acinar Score (AS)” in predicting POPF based on acinar cell counts histologically confirmed during surgery.</div></div><div><h3>Methods</h3><div>Patients who underwent pancreaticoduodenectomy (PD) at a single institution were enrolled. An expert pathologist evaluated and scored acinar cell density, along a scale from 1 (full acinar density) to 5 (no cells), on hematoxylin-and-eosin-stained slides of the pancreatic resection margin. The accuracy of POPF (grade B/C) prediction between the SPT and the AS was compared.</div></div><div><h3>Results</h3><div>Among the 55 patients with a hard pancreas, discrepancies between intraoperative palpation and histological acinar cell density (≥50 %; AS 1–2) were observed in 22 cases (40 %), of whom 4 (18.2 %) developed POPF. Patients with &lt;50 % acinar density (AS 3–5) did not have POPF, irrespective of the pancreatic texture. Multivariate analysis revealed that AS≥ 2 and SPT were independent predictors of POPF. The combined model incorporating both SPT and AS yielded a higher AUC than either factor alone.</div></div><div><h3>Conclusions</h3><div>Objective acinar cell density assessment highlights discrepancies in traditional tactile evaluations for predicting POPF. AS strengthens the subjective findings of pancreatic texture evaluation in patients undergoing PD.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 6","pages":"Pages 967-973"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144848259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic hydatid cyst: An ongoing enigma","authors":"Basil Babu,&nbsp;Vishal Gupta","doi":"10.1016/j.pan.2025.08.009","DOIUrl":"10.1016/j.pan.2025.08.009","url":null,"abstract":"","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 6","pages":"Pages 994-995"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P62/Sequestosome1 deficiency disrupts antioxidant and stress homeostasis during acute pancreatitis without exacerbating inflammation","authors":"Wenting Chen ,&nbsp;Jingren Wang ,&nbsp;Eiji Warabi ,&nbsp;Mai Imasaka ,&nbsp;Yuki Takeda ,&nbsp;Hiroshi Nishiura ,&nbsp;Satoru Takahashi ,&nbsp;Masaki Ohmuraya","doi":"10.1016/j.pan.2025.07.416","DOIUrl":"10.1016/j.pan.2025.07.416","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Acute pancreatitis (AP) is a common inflammatory disease of the pancreas, characterized by complex pathogenesis and limited specific treatment options. The selective autophagy adapter protein p62/sequestosome1 emerged as a key player in cellular stress responses, with emerging evidence suggesting its role in modulating both infection-driven and sterile inflammation. However, the role of <em>p62</em> in the pathogenesis of AP remains unclear.</div></div><div><h3>Methods</h3><div>To investigate the role of <em>p62</em> in AP, we generated pancreas-specific conditional knockout mice <em>(p62</em>^<em>ff</em><em>; Ptf1a</em>^{<em>cre/+</em>}) and induced AP by 12 repeated intraperitoneal cerulein injections. Mice were sacrificed either 1 h or 8 h after the final injection. Pancreatic damage was assessed along with serum amylase levels, intrapancreatic trypsin activity, proinflammatory cytokines, antioxidant genes, ER stress and cell death markers using immunohistochemistry, qRT-PCR, and western blotting.</div></div><div><h3>Results</h3><div><em>p62</em>^<em>ff</em><em>; Ptf1a</em>^{<em>cre/+</em>} mice showed normal growth and pancreatic development. Upon cerulein challenge, both <em>p62</em> knockout and control mice developed comparable pancreatic injury, without significant differences in histological scores, amylase, or trypsin activity. However, <em>p62</em>-deficient mice displayed significantly impaired antioxidant responses. Notably, <em>Nqo1</em> expression was reduced and Keap1 accumulated, indicating disrupted Nrf2 signaling. Ferroptosis markers also showed genotype- and time-dependent changes: GPX4 was reduced at 1 h, while FTH1 without significant differences in <em>p62</em>-deficient mice. Periodic acid–Schiff staining further revealed increased glycogen depletion in knockout mice, suggesting elevated metabolic stress.</div></div><div><h3>Conclusions</h3><div>These findings suggest that while <em>p62</em> deletion does not affect overall AP severity, it compromises redox homeostasis and metabolic recovery, highlighting a protective role for <em>p62</em> during pancreatic injury.</div></div>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":"25 6","pages":"Pages 832-842"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}