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    Keywords: CELLS ; tumor ; CELL ; Germany ; neoplasms ; imaging ; TOOL ; DISEASE ; DISEASES ; RESOLUTION ; SURGERY ; MECHANISM ; MARKER ; prognosis ; AUTOIMMUNE-DISEASE ; mechanisms ; T cell ; T cells ; T-CELL ; T-CELLS ; treatment ; MARKERS ; RESECTION ; LOCALIZATION ; HEAD ; ATROPHY ; FUTURE ; DIABETES-MELLITUS ; AUTOANTIBODIES ; autoimmune pancreatitis ; PRIMARY SCLEROSING CHOLANGITIS ; SJOGRENS-SYNDROME ; INFLAMMATORY-BOWEL-DISEASE ; FEATURES ; fibrosis ; INFILTRATION ; inflammatory bowel disease ; AUTOIMMUNE-DISEASES ; STENOSIS ; LEVEL ; pancreatic ; MASS ; autoimmune disease ; TOOLS ; DUCT ; serological ; Diabetes Mellitus ; surgical resection ; BOWEL ; EFFECTIVE STEROID-THERAPY ; ENTITY ; IgG4 ; pancreatic neoplasms ; pancreatic tumor ; PSEUDOTUMOROUS PANCREATITIS ; SERUM IGG4 ; steroids ; URSODEOXYCHOLIC ACID
    Abstract: The term autoimmune pancreatitis (AIP) describes a nonalcoholic, chronic lymphoplasmocytic pancreatitis. The lymphoplasmocytic infiltration is characterized by periductal localization of predominantly CD4-positive T cells, fibrosis, and acinar atrophy, frequently resulting in stenosis of the main pancreatic and distal common bile ducts. Imaging studies often reveal a diffuse narrowing of the pancreatic main duct and swelling of the pancreatic head wrongly suggesting the presence of a malignant tumor. Clinical signs include mild abdominal pain,jaundice, recurrent episodes of acute pancreatitis, and even new-onset diabetes mellitus. Additionally, AIP can be associated with other autoimmune diseases such as Sjogren's syndrome, primary sclerosing cholangitis, chronic inflammatory bowel diseases, and retroperitoneal fibrosis. Serological markers include autoantibodies and increased levels of gamma globulin and especially IgG4. Steroids seem to be effective in improving clinical symptoms as well as in the resolution of pancreatic and bile duct narrowing. This distinguishes AIP from other forms of pancreatitis and from pancreatic neoplasms. Further studies of the underlying pathophysiologic mechanisms, prognosis, and new diagnostic tools are needed to provide adequate and effective treatment in the future. In this article, we summarize the current knowledge about AIP and present 17 cases that underwent surgical resection at our institution from 2003 to 2004
    Type of Publication: Journal article published
    PubMed ID: 17007063
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  • 2
    Keywords: Germany ; human ; DISEASE ; DISEASES ; PROTEIN ; MICE ; PATIENT ; ACID ; HUMANS ; mass spectrometry ; tandem mass spectrometry ; TANDEM MASS-SPECTROMETRY ; PATHOGENESIS ; MASS-SPECTROMETRY ; STRATEGIES ; RANDOMIZED-TRIAL ; ULCERATIVE-COLITIS ; CROHNS-DISEASE ; rodent ; INFLAMMATORY-BOWEL-DISEASE ; COLITIS ; GASTRIC-MUCOSA ; GASTRODUODENAL MUCOSAL PROTECTION ; inflammatory bowel disease ; phosphatidylcholine ; SPHINGOMYELIN ; USA ; ACID-RESIDUES ; NOV ; lipid ; PULMONARY SURFACTANT ; therapeutic ; STRATEGY ; INVESTIGATE ; CD ; COLONIC-MUCOSA ; EXTRACTS ; G-Protein ; GASTROINTESTINAL MUCUS ; lysophosphatidylcholine ; nano ESI mass spectrometry
    Abstract: Background: Phospholipids are essential for the normal function of the intestinal mucus barrier. The objective of this study was to systematically investigate phospholipids in the intestinal mucus of humans Suffering from inflammatory bowel diseases, where it barrier defect is strongly supposed to be pathogenetic. Methods: Optimal mucus recovery was first validated in healthy mice and the method was then transferred to the endoscopic acquisition of ileal and colonic mucus from 21 patients with ulcerative colitis (UC), 10 patients with Crohn's disease (CD), and 29 healthy controls. Nano-electrospray ionization tandem mass spectrometry (ESI-MS/MS) was used to determine phosphatidylcholine (PC), lysophosphatidylcholine (LPC), and sphingomyelin (SM) in lipid extracts of mucus specimens. Results: Human and rodent mucus contained very similar phospholipid species. In the ileal and colonic mucus from patients suffering from UC, the concentration of PC was highly significantly lower (607 +/- 147 pmol/100 mu g protein and 745 +/- 148 pmol/100 mu g protein) compared to that of patients with CD (3223 +/- 1519 pmol/100 mu g protein and 2450 +/- 431 pmol/100 mu g protein) and to controls (3870 +/- 760 pmol/100 mu g protein and 2790 +/- 354 pmol/100 mu g protein), overall, P = 0.0002 for ileal specimens and P 〈 0.0001 tor colonic specimens. Independent of disease activity, patients suffering from UC showed an increased Saturation grade of PC fatty acid residues and it higher LPC-to-PC ratio. Conclusions: The intestinal mucus barrier of patients with UC is significantly altered concerning its phospholipid concentration and species composition. These alterations may be very important for the pathogenesis of this disease and underline new therapeutic strategies
    Type of Publication: Journal article published
    PubMed ID: 19504612
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