Liver, Pancreas, and Biliary TractAutoimmune-related pancreatitis is associated with autoantibodies and a Th1/Th2-type cellular immune response☆,☆☆
Section snippets
Subjects
Between 1987 and 1999, 24 of 313 patients with pancreatitis (11 men and 13 women) were diagnosed with AIP at the Kyoto University Hospital and satellite hospitals. In the present study, 17 patients (8 men and 9 women), who were prospectively diagnosed with AIP, were analyzed (Table 1). We diagnosed AIP as follows5, 6, 7, 8, 9, 10: (1) clinical symptoms associated with pancreatitis, (2) increased pancreatic enzyme or decreased pancreatic exocrine function, (3) increased serum gammaglobulin level
Autoantibodies
More than one autoantibody was detected in all 17 patients (Table 1). ANA was detected in 13 of 17 patients, ALF in 13, ACA-II in 10, RF in 5, and ASTHMA in 3. However, AMA was absent in all cases. Three patients without hypergammaglobulinemia had ACA-II or ALF (patients 3, 6, and 7). Two patients (patients 4 and 14) had neither ACA-II nor ALF. On the other hand, the patients with alcoholic or gallstone-related pancreatitis had no autoantibodies, except for ANA in 1 alcoholic patient (Table 2).
Discussion
Various pathophysiological hypotheses have been proposed for chronic pancreatitis.21, 22, 23, 24, 25, 26 Although alcohol and gallstone are common factors in the development of human pancreatitis, the underlying pathogenic mechanisms are still unclear. Recent observations suggest a functional role of T lymphocytes, such as cytotoxicity27 or the neuroimmune interactions in human pancreatitis.28 Chronic pancreatitis sometimes coexists with SjS, PSC, or PBC,11, 12, 13, 14, 15 which suggests the
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Supported by a Grant-in-Aid for Scientific Research (C) of the Ministry of Culture and Science of Japan (11670495); a Grant-in-Aid for the “Research for the Future” Program from The Japan Society for Promotion of Science (JSPS-RFTF97I00201); and Supporting Research Funds from The Japanese Foundation for Research and Promotion of Endoscopy (JFE-1997).
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Address requests for reprints to: Kazuichi Okazaki, M.D., Ph.D., Department of Gastroenterology and Endoscopic Medicine, Kyoto University Hospital, Shogoin-Kawaracho, Sakyo, Kyoto, 606-8507, Japan. e-mail: [email protected]; fax: (81)-75-751-3414.