Transforming growth factor beta, fibrogenesis and hyperglycemia in patients with chronic pancreatitis

It has been suggested that transforming growth factor beta (TGFb) mediates liver fibrosis, which can be monitored by the serum determination of the N- terminal peptide of type III procollagen (PIIIP) and laminin. Fibrosis is a lso an important phenomenon in patients with chronic pancreatitis (CP). In 23 patients with CP, 38 with liver cirrhosis (LC) and 20 healthy controls w e compared the serum patterns of PIIIP, laminin and TGFb and assessed wheth er in CP these markers are correlated with exocrine and endocrine function. In patients with LC, PIIIP and laminin levels were significantly higher, w hereas TGFb levels were significantly lower than those of controls. In CP p atients, no significant variations were found for PIIIP and laminin, althou gh levels were high in 7/23 and in 5/23 patients, respectively. TGFb levels in CP patients were higher than those in LC patients, levels being raised in 6/23 patients. In LC patients an inverse correlation was found between P IIIP and TGFb, whereas in CP patients, a direct correlation was found betwe en TGFb and PIIIP. Moreover, in CP patients, there was also a positive corr elation between TGFb and fasting serum glucose levels, while laminin was co rrelated with PABA test results. In conclusion: serum biochemical markers o f liver fibrosis can be considered of limited value in assessing pancreatic fibrosis; in liver cirrhosis there may be a negative feed-back regulation between TGFb production and the fibrogenetic process; and in chronic pancre atitis TGFb appears to favor fibrosis on the one hand and the development o f hyperglycemia on the other.