Year 2013 Vol. 21 No 1

GENERAL AND SPECIAL SURGERY

V.A. KLOPOVA, I.V. SAMSONOVA

INFLAMMATION INFLUENCE ON THE CHARACTER OF NEUROFILAMENT EXPRESSION IN THE PANCREAS AT CHRONIC PANCREATITIS

EE ‘Vitebsk State Medical University”
The Republic of Belarus

Objectives. To study dependence of NF (neurofilament) expression degree on the inflammation process severity in pancreas at chronic pancreatitis.
Methods. Using morphological, immunohistochemical, morphometric and statistical methods, we investigated the pancreas tissue specimens of 43 patients with chronic pancreatitis who underwent duodenum saving resection of the head of the pancreas. Control group included 5 pancreas head specimens of people died due to by accidents and without any pathology of pancreas. After staining with hematoxylin and eosin according to Van-Gizon method as well as immunohistochemical method (NF) at ×100, ×200, ×400 magnification, we estimated changes in the pancreas, lymphocytic (including perineural) inflammatory infiltration and the character of neurofilament expression.
Results. Involvement of the nervous tissue in the inflammatory process and its changes was demonstrated morphologically combined with the lymphocytic inflammatory infiltration, diffuse degenerative and expressed fibrous changes in the pancreas at chronic pancreatitis.
Severity of perineural inflammation varied in limits from 0,2 up to 1,714, median was equal to 0,914 (0,658-1,198). At the same time with the severity increasing of the inflammatory perineural lymphocytic infiltration the tendency to reduction of the NF expression degree, a marker of expressed mature and viable nervous tissue, as well as of the percentage of positively expressed nervous elements was observed.
The revealed link between the severity of the inflammatory changes and reduction of the size of mature and viable nervous tissue, testifying to the change of neurofilament expression degree, proves the dominance of the alteration processes of the nervous elements over the reparation in the pancreas in chronic pancreatitis.
Conclusions. The revealed changes testify to the straight role of the inflammation and the nervous component affection in chronic pancreatitis and are considered to be one of the pathogenetic mechanisms of the pain syndrome development in patients with chronic pancreatitis and progressive degenerative changes in the pancreas.

Keywords: chronic pancreatitis, nerve tissue, neurofilament, inflammation
p. 29 – 35 of the original issue
References
  1. Shalimov AA, Grubnik VV, Gorovits D. Khronicheskii pankreatit. Sovremennye kontseptsii patogeneza, diagnostiki i lecheniia [Chronic pancreatitis. Current concepts of the pathogenesis, diagnosis and treatment]. Kiev, Ukraine: Zdorov,ia; 2000. p. 230.
  2. Lowenfels AB, Maisonneuve P, Cavallini G, Ammann RW, Lankisch PG, Andersen JR, DiMagno EP, Andren-Sandberg A, Domellof L, Di Francesco V, et al. Prognosis of chronic pancreatitis: an international multicenter study. International Pancreatitis Study Group. Am J Gastroenterol. 1994 Sep;89(9):1467–71.
  3. Erkan M, Weis N, Pan Z, Schwager C, Samkharadze T, Jiang X, Wirkner U, Giese NA, Ansorge W, Debus J, Huber PE, Friess H, Abdollahi A, Kleeff J. Organ-, inflammation- and cancer specific transcriptional fingerprints of pancreatic and hepatic stellate cells. Mol Cancer. 2010 Apr 23;9:88.
  4. Shimizu K. Pancreatic stellate cells: molecular mechanism of pancreatic fibrosis. J Gastroenterol Hepatol. 2008 Mar;23(Suppl. 1):S119–21.
  5. Bachem MG, Zhou Z, Zhou S, Siech M. Role of stellate cells in pancreatic fibrogenesis associated with acute and chronic pancreatitis. J Gastroenterol Hepatol. 2006 Oct;21(Suppl. 3):S92–6.
  6. Gress TM, Menke A, Bachem M, Muller-Pillasch F, Ellenrieder V, Weidenbach H, Wagner M, Adler G. Role of extracellular matrix in pancreatic diseases. Digestion. 1998 Nov-Dec;59(6):625–37.
  7. Masamune A, Shimosegawa T. Signal transduction in pancreatic stellate cells. J Gastroenterol. 2009;44(4):249–60.
  8. Layer P, Yamamoto H, Kalthoff L, Clain JE, Bakken LJ, DiMagno EP.The different courses of early- and late-onset idiopathic and alcoholic chronic pancreatitis. Gastroenterology. 1994 Nov;107(5):1481–87.
  9. Dominguez-Munoz JE. Management of maldigestion in chronic pancreatitis: a practical protocol. In: Clinical Pancreatology for. Practising Gastroenterologists and Surgeons. Dominguez-Munoz JE (ed). Oxford, UK: Blackwell Publishing; 2005. p. 288–93.
  10. Gubergrits NB. Khronicheskaia abdominal'naia bol'. Pankreaticheskaia bol': kak pomoch' bol'nomu [Chronic abdominal pain. Pancreatic pain: how to help the patient]. Moscow, RF: ID Medpraktika; 2005. 176 p.
  11. Buscher HC, Jansen JB, van Dongen R, Bleichrodt RP, van Goor H. Long-term results of bilateral thoracoscopic splanchnicectomy in patients with chronic pancreatitis. Br J Surg. 2002 Feb;89(2):158–62.
  12. Vasilenko AM. Neiroendokrinnoimmunnye mekhanizmy bolevykh sindromov [Neuroendocrine Immune mechanisms of pain syndromes]. Bol' i ee lechenie. 2000;(12):4–10.
  13. Ceyhan GO, Demir IE, Maak M, Friess H. Fate of nerves in chronic pancreatitis: Neural remodeling and pancreatic neuropathy. Best Pract Res Clin Gastroenterol. 2010 Jun;24(3):311–22.
  14. Klopova VA, Samsonova IV, Shchastnyi AT, Kugaev MI. Kharakter ekspressii neirofilamenta v podzheludochnoi zheleze pri khronicheskom pankreatite [The expression of neurofilament in the pancreas in chronic pancreatitis]. Novosti Khirurgii. 2012;20(2):9–13.
  15. Jura N, Archer H, Bar-Sagi D. Chronic pancreatitis, pancreatic adenocarcinoma and the black box in-between. Cell Res. 2005 Jan;15(1):72–7.
  16. Bockman DE, Buchler M, Malfertheiner P, Beger HG. Analysis of nerves in chronic pancreatitis. Gastroenterology. 1988 Jun;94(6):1459–69.
  17. Fink T, Di Sebastiano P, Buchler M, Beger HG, Weihe E. Growth-associated protein-43 and protein gene-product 9.5 innervation in human pancreas: changes in chronic pancreatitis. Neuroscience. 1994 Nov;63(1):249–66.
  18. Di Sebastiano P, Fink T, Weihe E, Friess H, Innocenti P, Beger HG, Buchler MW. Immune cell infiltration and growth-associated protein 43 expression correlate with pain in chronic pancreatitis. Gastroenterology. 1997 May;112(5):1648–55.
  19. Buchler M, Weihe E, Friess H, Malfertheiner P, Bockman E, Muller S, Nohr D, Beger HG. Changes in peptidergic innervation in chronic pancreatitis. Pancreas. 1992;7(2):183–92.
Address for correspondence:
210023, Respublika Belarus', g. Vitebsk, pr. Frunze, 27, UO «Vitebskii gosudarstvennyi meditsinskii universitet», kafedra patologicheskoi anatomii,
e-mail: victoriya_06@tut.by,
Klopova Viktoriia Aleksandrovna
Information about the authors:
Klopova V.A. A post-graduate student of the pathologic anatomy chair of EE “Vitebsk State Medical University”.
Samsonova I.V. PhD, associate professor, head of the pathologic anatomy chair of EE “Vitebsk State Medical University”.
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