Objective
To evaluate the parameters that mediate fibrogenesis in chronic pancreatiti
s (CP).
Background
Connective tissue growth factor (CTGF), which is regulated by transforming
growth factor beta (TGF-beta), has recently been implicated in skin fibrosi
s and atherosclerosis. in the present study, the authors analyzed the conco
mitant presence of TGF-beta 1 and its signaling receptors-TGF-beta receptor
I, subtype ALK5 (T beta R-I-ALK5), and TGF-beta receptor II (T beta R-II)-
as well as CTGF and collagen type I in the pancreatic tissue of patients un
dergoing surgery for chronic pancreatitis.
Patients and Methods
CP tissue samples were obtained from 40 patients (8 women, 32 men) undergoi
ng pancreatic resection. Tissue samples of 25 previously healthy organ dono
rs (12 women, 13 men) served as controls. The expression of TGF-beta 1, T b
eta R-I-ALK5, T beta R-II, CTGF, and collagen type I was studied by Norther
n blot analysis. By in situ hybridization and immunohistochemistry, the res
pective mRNA moieties and proteins were localized in the tissue samples.
Results
Northern blot analysis showed that CP tissue samples exhibited concomitant
enhanced mRNA expression of TGF-beta 1 (38-fold), T beta R-II (5-fold), CTG
F (25-fold), and collagen type I (24-fold) compared with normal controls. I
n addition, T beta R-I-ALK5 mRNA was increased in 50% of CP tissue samples
(1.8-fold). By in situ hybridization, TGF-beta 1, T beta R-I-ALK5, and T be
ta R-II mRNA were often seen to be colocalized, especially in the ductal ce
lls and in metaplastic areas where atrophic acinar cells appeared to dediff
erentiate into ductal structures. In contrast, CTGF was located in degenera
ting acinar cells and principally in fibroblasts surrounding these areas; M
oreover, CTGF mRNA expression levels correlated positively with the degree
of fibrosis in CP tissues.
Conclusion
The concomitant overexpression of CTGF, collagen type I, TGF-beta 1, and it
s signaling receptors in CP suggests that these proteins contribute to enha
nced extracellular matrix synthesis and accumulation, resulting finally in
the fibrogenesis observed in CP.