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Cell Stem Cell Jan 2022Human organoid model systems lack important cell types that, in the embryo, are incorporated into organ tissues during development. We developed an organoid assembly...
Human organoid model systems lack important cell types that, in the embryo, are incorporated into organ tissues during development. We developed an organoid assembly approach starting with cells from the three primary germ layers-enteric neuroglial, mesenchymal, and epithelial precursors-that were derived separately from human pluripotent stem cells (PSCs). From these three cell types, we generated human antral and fundic gastric tissue containing differentiated glands surrounded by layers of smooth muscle containing functional enteric neurons that controlled contractions of the engineered antral tissue. Using this experimental system, we show that human enteric neural crest cells (ENCCs) promote mesenchyme development and glandular morphogenesis of antral stomach organoids. Moreover, ENCCs can act directly on the foregut to promote a posterior fate, resulting in organoids with a Brunner's gland phenotype. Thus, germ layer components that are derived separately from PSCs can be used for tissue engineering to generate complex human organoids.
Topics: Cell Differentiation; Endoderm; Humans; Neural Crest; Organoids; Pluripotent Stem Cells
PubMed: 34856121
DOI: 10.1016/j.stem.2021.10.010 -
Advances in Therapy Jun 2021Brunner's gland hamartoma is a benign tumor of the duodenum, but has malignant potential with a very low risk of progression into adenocarcinoma. It is uncommon with a... (Review)
Review
Brunner's gland hamartoma is a benign tumor of the duodenum, but has malignant potential with a very low risk of progression into adenocarcinoma. It is uncommon with a frequency of less than 1.0% among the primary tumors of the small intestine. In addition, its clinical manifestations are nonspecific, etiology remains unclear, and treatment strategy needs to be further refined. This literature review mainly discusses the epidemiology, clinical features, possible etiology and pathogenesis, diagnostic methods, malignant potential, treatment, and prognosis of Brunner's gland hamartoma.
Topics: Adenocarcinoma; Brunner Glands; Duodenum; Hamartoma; Humans
PubMed: 33914269
DOI: 10.1007/s12325-021-01750-6 -
British Journal of Pharmacology Feb 2022The incretin hormone glucagon-like peptide-1 (GLP-1) is inactivated by the enzyme dipeptidyl peptidase-4 even before it leaves the gut, but it seems to act predominantly... (Review)
Review
The incretin hormone glucagon-like peptide-1 (GLP-1) is inactivated by the enzyme dipeptidyl peptidase-4 even before it leaves the gut, but it seems to act predominantly via activation of intestinal sensory neurons expressing GLP-1 receptors. Thus, activation of vagal afferents is probably responsible for its effects on appetite and food intake, gastrointestinal secretion and motility, and pancreatic endocrine secretion. However, GLP-1 receptors are widely expressed in the gastrointestinal (GI) tract, including epithelial cells in the stomach, and the Brunner glands, in endocrine cells of the gut epithelium, and on mucosal lymphocytes. In this way, GLP-1 may have important local actions of epithelial protection and endocrine signalling and may interact with the immune system. We review the formation and release of GLP-1 from the endocrine L cells and its fate after release and describe the localization of its receptor throughout the GI tract and discuss its direct or indirect actions in the GI tract. LINKED ARTICLES: This article is part of a themed issue on GLP1 receptor ligands (BJP 75th Anniversary). To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v179.4/issuetoc.
Topics: Gastrointestinal Tract; Glucagon-Like Peptide 1; Glucagon-Like Peptide-1 Receptor; Ligands
PubMed: 34235727
DOI: 10.1111/bph.15611 -
Nature Communications Mar 2023The subtypes of duodenal cancer (DC) are complicated and the carcinogenesis process is not well characterized. We present comprehensive characterization of 438 samples...
The subtypes of duodenal cancer (DC) are complicated and the carcinogenesis process is not well characterized. We present comprehensive characterization of 438 samples from 156 DC patients, covering 2 major and 5 rare subtypes. Proteogenomics reveals LYN amplification at the chromosome 8q gain functioned in the transmit from intraepithelial neoplasia phase to infiltration tumor phase via MAPK signaling, and illustrates the DST mutation improves mTOR signaling in the duodenal adenocarcinoma stage. Proteome-based analysis elucidates stage-specific molecular characterizations and carcinogenesis tracks, and defines the cancer-driving waves of the adenocarcinoma and Brunner's gland subtypes. The drug-targetable alanyl-tRNA synthetase (AARS1) in the high tumor mutation burden/immune infiltration is significantly enhanced in DC progression, and catalyzes the lysine-alanylation of poly-ADP-ribose polymerases (PARP1), which decreases the apoptosis of cancer cells, eventually promoting cell proliferation and tumorigenesis. We assess the proteogenomic landscape of early DC, and provide insights into the molecular features corresponding therapeutic targets.
Topics: Humans; Duodenal Neoplasms; Proteogenomics; Brunner Glands; Adenocarcinoma; Carcinogenesis
PubMed: 36991000
DOI: 10.1038/s41467-023-37221-5 -
Surgery Journal (New York, N.Y.) Jan 2022Brunner's gland hamartomas (BGH) are rare benign lesions with an incidence of <0.01%, accounting for 5 to 10% of all benign tumors of the duodenum. It requires...
Brunner's gland hamartomas (BGH) are rare benign lesions with an incidence of <0.01%, accounting for 5 to 10% of all benign tumors of the duodenum. It requires expeditious management by a multidisciplinary team. The aim of the study is to report our experience with surgery for BGH. Data of all patients who underwent surgical intervention for duodenal polypoidal mass between August 2007 and March 2020 were retrieved from our prospectively maintained gastrointestinal (GI) surgery database. All patients whose histopathology report of the resected specimen confirmed BGH ( = 9) were included in the present study. Other pathological diagnosis like duodenal lipoma ( = 2), ganglioneuroma ( = 1), adenoma ( = 10), and adenocarcinoma ( = 4) were excluded. Nine patients had confirmatory histopathological diagnosis of BGH and met our inclusion criteria. Three (33.3%) of them were men with a median age of 45 (range: 24-61) years. The median interval between onset of symptoms and diagnosis of duodenal polyp was 14 (range: 4-180) days. Five patients (55.5%) presented with upper GI hemorrhage. Three (33.3%) patients presented with abdominal pain, and one (11.1%) patient presented with episodes of bilious vomiting. Diagnostic endoscopy could detect the lesion in all (100%) patients. Contrast-enhanced computed tomography detected duodenal polypoidal lesion in five (55.5%) patients. The mean size of tumor was 4.78 ± 1.36 cm. These lesions were symptomatic in all the patients and warranted intervention. In view of failed endoscopic intervention ( = 7, 77.7%), or extramural extension of the tumor ( = 2, 22.2%), surgical intervention was considered. Most commonly performed operation was duodenal polypectomy ( = 6, 66.6%). Three postoperative complications developed in two (22.2%) patients. There was no surgery-related mortality. After a median follow-up of 60 (12 -78) months, no patient developed GI bleed or intestinal obstruction. In this study, the clinical profile of BGH was explored from the surgeon's point of view. Although endoscopic management is the first-line treatment, surgery plays an important role, particularly, if this fails or is not feasible. In experienced hand, surgery can be performed with acceptable perioperative morbidity and mortality and long-term satisfactory outcomes.
PubMed: 35059497
DOI: 10.1055/s-0041-1741510 -
Journal of Investigative Medicine High... 2023Brunner gland hamartoma (BGH) is a rare condition that requires a high clinical suspicion to diagnose. Large hamartomas may initially present with iron deficiency anemia...
Brunner gland hamartoma (BGH) is a rare condition that requires a high clinical suspicion to diagnose. Large hamartomas may initially present with iron deficiency anemia (IDA) or symptoms suggesting intestinal obstruction. Barium swallow may demonstrate the lesion, but endoscopic evaluation is the acceptable first line management unless a concern for underlying malignancy. The present case report and literature review highlight the uncommon presentations and endoscopic role in large BGHs management. Internists should consider BGH in their differential, especially in patient with occult bleeding, IDA, or obstruction, which can be treated with endoscopic resection of large sized tumors by trained experts.
Topics: Humans; Brunner Glands; Duodenal Diseases; Hamartoma
PubMed: 36891571
DOI: 10.1177/23247096231159811 -
International Journal of Surgery Case... Nov 2022Brunner gland hamartoma is rare duodenal neoplasm. These benign lesions are usually presented by upper gastrointestinal bleeding and sometimes extend to cause intestinal...
INTRODUCTION
Brunner gland hamartoma is rare duodenal neoplasm. These benign lesions are usually presented by upper gastrointestinal bleeding and sometimes extend to cause intestinal obstruction.
PRESENTATION OF THE CASE
We report a case of a 43-year-old male patient manifested with iron deficiency anemia. Upon investigations, computed topography (CT) scan found a dilated first part of the duodenum with presence of large pedunculated polyp. The histopathological examination revealed a submucosal lobular proliferation of duodenal Brunner's gland separated by a fine fibrous septum. No dysplastic signs were observed. Immunohistochemical studies confirmed the nature of the glands and reveled absence of Helicobacter pylori gastritis. Diagnosis was confirmed.
DISCUSSION
Brunner glands hamartomas are rare tumors. They are commonly presented by upper GI bleeding and intestinal obstruction. The pathogenesis remains unclear. They are usually located in the first part (bulb) of the duodenum. Mucosal irritation and Helicobacter pylori infection are suggested causes. Different surgical and endoscopical modalities are applied in the management depending on the size and location of the mass. In our case, the tumor was removed by Endoscopic submucosal dissection.
CONCLUSION
Brunner gland hamartoma is a rare usually benign tumor. Presented clinically by upper GI bleeding and obstruction. Histopathologically Brunner gland Hamartoma characterized by lobular proliferation of Brunner gland associated with presence of other mature tissues. Although these tumors are benign it carries a minor risk of malignant transformation.
PubMed: 36270207
DOI: 10.1016/j.ijscr.2022.107747 -
ACG Case Reports Journal Dec 2022Brunner's gland adenoma is extremely uncommon small bowel tumors with an incidence of <0.01% and account for less than 1% of all gastrointestinal tumors. They are...
Brunner's gland adenoma is extremely uncommon small bowel tumors with an incidence of <0.01% and account for less than 1% of all gastrointestinal tumors. They are branched acinotubular glands found within the submucosal layer and located between the pyloric ring and the major duodenal papilla. Brunner's glands produce an alkaline secretion containing viscous mucin to protect the duodenum from acidic gastric chyme. Although these lesions are usually asymptomatic and are incidentally discovered on upper gastrointestinal endoscopy, they may occasionally present with symptoms of upper gastrointestinal hemorrhage, duodenal obstruction, and more rarely with biliary fistulation or intussusception. We present an atypical case of a large 9-cm Brunner's gland adenoma causing duodenojejunal intussusception in a 44-year-old Chinese man, who presented with long-standing epigastric pain, nausea, and vomiting.
PubMed: 36628374
DOI: 10.14309/crj.0000000000000949 -
ACG Case Reports Journal Jun 2023Malignant neoplasms arising from the Brunner gland are exceedingly rare. A 62-year-old man with a history of surgical resection of Brunner gland adenocarcinoma presented...
Malignant neoplasms arising from the Brunner gland are exceedingly rare. A 62-year-old man with a history of surgical resection of Brunner gland adenocarcinoma presented with upper extremity cellulitis. Hospital course was complicated by atrial fibrillation and hematochezia. Bidirectional endoscopy was negative; however, small bowel enteroscopy revealed recurrence of Brunner gland adenocarcinoma 6 years after surgical resection. To our knowledge, this is the first reported case of recurrent Brunner gland adenocarcinoma after curative resection.
PubMed: 37305801
DOI: 10.14309/crj.0000000000001060 -
Cureus Apr 2020A 57-year-old male with a history of gastroesophageal reflux disease and esophageal strictures presented with melena and abdominal pain. He underwent an...
A 57-year-old male with a history of gastroesophageal reflux disease and esophageal strictures presented with melena and abdominal pain. He underwent an esophagogastroduodenoscopy, which revealed a 5-cm duodenal bulb mass causing partial obstruction of the gastric outlet. Endoscopic ultrasound showed a 5-cm, hypoechoic lesion, arising from the mucosal layer, with a large blood vessel feeding the lesion. Biopsy revealed benign Brunner's gland hyperplasia. The large mass was causing symptomatic obstruction of the pylorus and iron deficiency anemia, and had risk for malignant transformation. Due to its size it was not amenable to endoscopic removal. Subsequently, he underwent exploratory laparotomy with pyloroplasty, duodenotomy and partial duodenal resection. Surgical pathology showed Brunner's gland hyperplasia and was negative for malignancy.
PubMed: 32377490
DOI: 10.7759/cureus.7542