Document Detail

Pancreatic neuropathy results in "neural remodeling" and altered pancreatic innervation in chronic pancreatitis and pancreatic cancer.
MedLine Citation:
PMID:  19568227     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Chronic pancreatitis (CP) and pancreatic cancer (PCa) are characterized by intrapancreatic neuropathic alterations, including increased neural density and hypertrophy, pancreatic neuritis and neural invasion (NI) by cancer cells in PCa. The aim of this study was to identify the influence of these neuropathic changes on the quality of pancreatic innervation, intrapancreatic glia, and visceral pain. METHODS: Pancreatic nerve fiber qualities were characterized by immunohistochemical visualization of various markers, including those for sympathetic (tyrosine hydroxylase, TH) and cholinergic innervation (choline acetyltransferase, ChAT), as well as the glial transcription factor, Sox10, and the neuroepithelial progenitor cell marker, Nestin, in normal pancreas (NP, n=16), CP (n=20), and PCa (n=20) patients. The neural immunoreactivity scores of these markers were correlated with the severity of intrapancreatic neuropathic changes and with abdominal pain sensation of patients. RESULTS: Pancreatic sympathetic innervation was significantly reduced in CP and PCa, whereas parasympathetic innervation did not show major changes. Nestin neuro-immunoreactivity was stronger, and Sox10-immunoreactivity was weaker in CP and PCa than in NP. Pancreatic sympathetic and cholinergic innervation was noticeably decreased in patients with severe pancreatic neuritis, NI by cancer cells, or abdominal pain. Moreover, the neural immunoreactivity for Sox10 and Nestin also varied with intrapancreatic neuropathic alterations and abdominal pain. CONCLUSIONS: The quality of intrapancreatic nerve fibers and the activation state of intrapancreatic glia in CP and PCa are strikingly different from those in normal pancreas. This novel phenomenon of "neural remodeling" shows how pancreatic neuropathic pain and "visceral neuropathy" are associated with altered pancreatic innervation in CP and PCa.
Güralp Onur Ceyhan; Ihsan Ekin Demir; Ulrich Rauch; Frank Bergmann; Michael W Müller; Markus W Büchler; Helmut Friess; Karl-Herbert Schäfer
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Publication Detail:
Type:  Journal Article     Date:  2009-06-30
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  104     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-06     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2555-65     Citation Subset:  IM    
Department of Surgery, Klinikum Rechts der Isar, Technische Universität München, Munich D-81675, Germany.
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MeSH Terms
Abdominal Pain / etiology
Biological Markers / analysis
Intermediate Filament Proteins / metabolism
Neoplasm Invasiveness
Nerve Tissue Proteins / metabolism
Neuritis / pathology*
Neuronal Plasticity
Pain Measurement
Pancreas / innervation*,  metabolism,  pathology
Pancreatic Neoplasms / metabolism,  pathology*
Pancreatitis, Chronic / metabolism,  pathology*
SOXE Transcription Factors / metabolism
Severity of Illness Index
Statistics, Nonparametric
Reg. No./Substance:
0/Biological Markers; 0/Intermediate Filament Proteins; 0/Nerve Tissue Proteins; 0/SOX10 protein, human; 0/SOXE Transcription Factors; 0/nestin

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