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Pancreas Nov 2015The pancreas produces enzymes with a digestive function and hormones with a metabolic function, which are produced by distinct cell types of acini and islets,... (Review)
Review
The pancreas produces enzymes with a digestive function and hormones with a metabolic function, which are produced by distinct cell types of acini and islets, respectively. Within these units, secretory cells coordinate their functioning by exchanging information via signals that flow in the intercellular spaces and are generated either at distance (several neural and hormonal inputs) or nearby the pancreatic cells themselves (inputs mediated by membrane ionic-specific channels and by ionic- and metabolite-permeant pannexin channels and connexin "hemichannels"). Pancreatic secretory cells further interact via the extracellular matrix of the pancreas (inputs mediated by integrins) and directly with neighboring cells, by mechanisms that do not require extracellular mediators (inputs mediated by gap and tight junction channels). Here, we review the expression and function of the connexins and pannexins that are expressed by the main secretory cells of the exocrine and endocrine pancreatic cells. Available data show that the patterns of expression of these proteins differ in acini and islets, supporting distinct functions in the physiological secretion of pancreatic enzymes and hormones. Circumstantial evidence further suggests that alterations in the signaling provided by these proteins are involved in pancreatic diseases.
Topics: Animals; Connexins; Humans; Islets of Langerhans; Models, Biological; Pancreas, Exocrine; Pancreatic Diseases; Pancreatic Juice; Protein Isoforms; Signal Transduction
PubMed: 26465951
DOI: 10.1097/MPA.0000000000000378 -
The Lancet. Gastroenterology &... Oct 2018Idiopathic recurrent acute pancreatitis is clinically challenging and has substantial socioeconomic consequences. Investigations are expensive and often reveal little... (Review)
Review
Idiopathic recurrent acute pancreatitis is clinically challenging and has substantial socioeconomic consequences. Investigations are expensive and often reveal little about the cause of the disease. Little is known about the interaction between genetic, environmental, anatomical, and other factors that contribute to the disease. Data on the efficacy, safety, and long-term outcomes of endoscopic therapies are scarce. The effect of idiopathic recurrent pancreatitis on quality of life is often underestimated. A more thorough examination of the causes of the disease and the roles of other associated risk factors is needed, as are well designed clinical studies with robust and objectively measurable outcomes. Ideally, evaluation of the causes of disease and therapy should be done only in specialised centres, should follow a protocol, and all outcomes should be formally assessed.
Topics: Acute Disease; Calculi; Cholecystectomy, Laparoscopic; Cost of Illness; Disease Management; Genetic Testing; Humans; Pancreatic Diseases; Pancreatitis; Quality of Life; Recurrence; Risk Factors
PubMed: 30215363
DOI: 10.1016/S2468-1253(18)30211-5 -
Pediatric Clinics of North America Feb 2021Pulmonary manifestations of gastrointestinal (GI) diseases are often subtle, and underlying disease may precede overt symptoms. A high index of suspicion and a low... (Review)
Review
Pulmonary manifestations of gastrointestinal (GI) diseases are often subtle, and underlying disease may precede overt symptoms. A high index of suspicion and a low threshold for consultation with a pediatric pulmonologist is warranted in common GI conditions. This article outlines the pulmonary manifestations of different GI, pancreatic, and liver diseases in children, including gastroesophageal reflux disease, inflammatory bowel disease, pancreatitis, alpha1-antitrypsin deficiency, nonalcoholic fatty liver disease, and complications of chronic liver disease (hepatopulmonary syndrome and portopulmonary hypertension).
Topics: Child; Echocardiography; Gastrointestinal Diseases; Humans; Liver Diseases; Lung Diseases; Pancreatic Diseases; Respiratory Function Tests
PubMed: 33228942
DOI: 10.1016/j.pcl.2020.09.002 -
Clinical Gastroenterology and... Jan 2019The gut microbiome increasingly is recognized for its role in human health and disease. Initial evidence has indicated that gut microbial dysbiosis is associated with... (Review)
Review
The gut microbiome increasingly is recognized for its role in human health and disease. Initial evidence has indicated that gut microbial dysbiosis is associated with several pancreatic diseases. Although it is not known if these associations are causative, gut dysbiosis is hypothesized to mediate chronic proinflammatory changes in the pancreas. Further mechanistic and epidemiologic studies of the microbiome are needed. Ultimately, targeted modulation of the microbiota could have therapeutic value.
Topics: Dysbiosis; Gastrointestinal Microbiome; Gastrointestinal Tract; Host Microbial Interactions; Humans; Pancreatic Diseases
PubMed: 30144522
DOI: 10.1016/j.cgh.2018.08.045 -
Cleveland Clinic Journal of Medicine Mar 2020Endoscopic ultrasonography (EUS) has been used since the mid-1980s. Initially a diagnostic tool, it has since evolved into a therapeutic, minimally invasive surgical... (Review)
Review
Endoscopic ultrasonography (EUS) has been used since the mid-1980s. Initially a diagnostic tool, it has since evolved into a therapeutic, minimally invasive surgical tool with significant impact on the diagnosis and management of a range of benign and malignant conditions. The authors review current indications, safety, and efficacy of EUS for diseases of the upper and lower gastrointestinal tract, posterior mediastinum, pancreas, bile duct, gallbladder, retroperitoneum, liver, adrenal glands, and kidneys.
Topics: Biliary Tract Diseases; Endosonography; Gastrointestinal Diseases; Gastrointestinal Tract; Humans; Pancreatic Diseases
PubMed: 32127442
DOI: 10.3949/ccjm.87a.19003 -
Radiologia 2018In addition to the classical morphological evaluation of pancreatic disease, the constant technological advances in imaging techniques based fundamentally on computed... (Review)
Review
In addition to the classical morphological evaluation of pancreatic disease, the constant technological advances in imaging techniques based fundamentally on computed tomography and magnetic resonance imaging have enabled the quantitative functional and molecular evaluation of this organ. In many cases, this imaging-based information results in substantial changes to patient management and can be a fundamental tool for the development of biomarkers. The aim of this article is to review the role of emerging functional and molecular techniques based on computed tomography and magnetic resonance imaging in the evaluation of pancreatic disease.
Topics: Aged; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pancreatic Diseases; Tomography, X-Ray Computed
PubMed: 30236460
DOI: 10.1016/j.rx.2018.07.004 -
Digestive Endoscopy : Official Journal... Jan 2024Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic technique used to diagnose and treat biliary and pancreatic diseases. It is one of the... (Review)
Review
Endoscopic retrograde cholangiopancreatography (ERCP) is an advanced endoscopic technique used to diagnose and treat biliary and pancreatic diseases. It is one of the most technically demanding endoscopic procedures. ERCP training programs must ensure trainees have adequate knowledge of the anatomy and physiology associated with biliopancreatic diseases. The variety of ERCP procedures included in training programs should provide sufficient basic training for novice trainees and advanced training for experienced endoscopists. The main endoscopic procedures should be trained in ascending order of difficulty. Incorporating models capable of simulating various clinical and anatomical conditions could provide an effective means of fulfilling training requirements, although they are not easily available due to expensive facilities and void of standard assessment. Competency assessment is crucial in ERCP training to ensure trainees can independently and safely perform ERCP. Because of the rapid advancement of diagnostic and therapeutic methods, postgraduate training is critical for ERCP practitioners. Once certificates are attained, practitioners are solely responsible for maintaining their competency, credentialing, and quality.
Topics: Humans; Cholangiopancreatography, Endoscopic Retrograde; Pancreatic Diseases
PubMed: 37792821
DOI: 10.1111/den.14702 -
Abdominal Radiology (New York) Feb 2016Despite advances in multimodality imaging of pancreas, there is still overlap between imaging findings of several pancreatic/peripancreatic disease processes. Pancreatic... (Review)
Review
Despite advances in multimodality imaging of pancreas, there is still overlap between imaging findings of several pancreatic/peripancreatic disease processes. Pancreatic and peripancreatic non-neoplastic entities may mimic primary pancreatic neoplasms on ultrasound, CT, and MRI. On the other hand, primary pancreatic cancer may be overlooked on imaging because of technical and inherent factors. The purpose of this pictorial review is to describe and illustrate pancreatic imaging pitfalls and highlight the basic radiological features for proper differential diagnosis.
Topics: Diagnosis, Differential; Humans; Multimodal Imaging; Pancreatic Diseases; Pancreatic Neoplasms
PubMed: 26867910
DOI: 10.1007/s00261-015-0557-y -
Praxis Jun 2016The author presents his personal choice of practical relevant papers of pancreatic diseases from 2014 to 2015. Nutritional factors and hypertriglycidemia are discussed... (Review)
Review
The author presents his personal choice of practical relevant papers of pancreatic diseases from 2014 to 2015. Nutritional factors and hypertriglycidemia are discussed as causes of acute pancreatitis. Tools to avoid post-ERCP(endoscopic retrograde cholangiopancreatography) pancreatitis are described and the natural course of fluid collections and pseudocysts is demonstrated. The value of secretin-MRCP(magnetic resonance cholangiopancreatography) for diagnosis of chronic pancreatitis is illustrated. Data help to choose the minimally effective prednisolone dose in autoimmune pancreatitis. The increased prevalence of fractures in patients with chronic pancreatitis highlights the necessity of screening for bone density loss. The association of vitamin D intake with pancreatic cancer is described. The probability of cancer in IPNM is shown and innovative surgical concepts to reduce the loss of pancreatic function are presented. Finally neoadjuvant concepts for the treatment of pancreatic cancer are highlighted.
Topics: Cholangiopancreatography, Endoscopic Retrograde; Humans; Pancreatic Diseases; Pancreatic Function Tests; Pancreatic Neoplasms; Pancreatic Pseudocyst; Pancreatitis, Acute Necrotizing; Pancreatitis, Chronic; Prognosis
PubMed: 27329710
DOI: 10.1024/1661-8157/a002397 -
American Journal of Physiology.... Apr 2015In this review we summarize the role of inflammasomes in pancreatic physiology and disease with a focus on acute pancreatitis where much recent progress has been made.... (Review)
Review
In this review we summarize the role of inflammasomes in pancreatic physiology and disease with a focus on acute pancreatitis where much recent progress has been made. New findings have identified inducers of and cell specificity of inflammasome component expression in the pancreas, the contribution of inflammasome-regulated effectors to pancreatitis, and metabolic regulation of inflammasome activation, which are strong determinants of injury in pancreatitis. New areas of pancreatic biology will be highlighted in the context of our evolving understanding of gut microbiome- and injury-induced inflammasome priming, pyroptosis, and innate immune-mediated regulation of cell metabolism.
Topics: Animals; Humans; Immunity, Innate; Inflammasomes; Inflammation Mediators; Pancreas; Pancreatic Diseases; Signal Transduction
PubMed: 25700081
DOI: 10.1152/ajpgi.00388.2014