Neutrophil infiltrations compared between types 1 and 2 autoimmune pancreatitis

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  • 1型自己免疫性膵炎（LPSP）と2型自己免疫性膵炎（IDCP）の好中球浸潤の比較
  • 1ガタ ジコ メンエキセイスイエン(LPSP)ト 2ガタ ジコ メンエキセイスイエン(IDCP)ノ コウチュウキュウ シンジュン ノ ヒカク

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Abstract

<p>Background: Type 2 autoimmune pancreatitis (AIP) is referred to as idiopathic duct-centric pancreatitis (IDCP)/AIP with granulocytic epithelial lesions and is histologically characterized by destruction of interlobular pancreatic duct epithelia associated with neutrophil infiltration and obstruction. Neutrophil infiltration around the pancreatic ducts is also seen. To elucidate the etiology of IDCP, we investigated the mechanisms underlying neutrophil infiltration in type 1 AIP, which is referred to as lymphoplasmacytic sclerosing pancreatitis (LPSP), and IDCP.</p><p>Method: This study was performed on resected pancreata from patients with alcoholic chronic pancreatitis (ACP, n=10), LPSP (n=10) and IDCP (n=12). Neutrophil numbers were counted around pancreatic ducts. Immunohistochemical staining was performed to measure the expressions of two neutrophil chemoattractants, i.e. granulocyte chemotactic protein-2 (GCP-2) and interleukin-8 (IL-8), in pancreatic duct epithelia. The following cell staining intensity grading system was applied: negative (0), weak (1), moderate (2), or strong (3).</p><p>Results: The median number of neutrophils around the interlobular pancreatic ducts was significantly higher in IDCP (15.16; interquartile range [IQR]: 9.74–18.41) than in ACP (2.66; IQR: 1.33–4.33) (P<0.05) and LPSP (3.16; IQR: 2.74–4.57) (P<0.01). There was no significant difference in the median number of neutrophils around the intralobular pancreatic ducts among ACP (1.16; IQR: 0.33–3.41), LPSP (3.16; IQR: 0.74–5.5) and IDCP (3.00; IQR: 1.08–7.91). The median score of GCP-2 in the interlobular pancreatic duct epithelia was significantly higher in IDCP (1.5; IQR: 0.25–2) than in ACP (0; IQR: 0–0.75) (P<0.05) and LPSP (0; IQR: 0–0.75) (P<0.05). There was no significant difference in the median score of IL-8 in the interlobular pancreatic duct epithelia among ACP (0; IQR: 0–0.75), LPSP (1; IQR: 0–1.75) and IDCP (0.5; IQR: 0–1).</p><p>Conclusions: In IDCP, neutrophil infiltration, which was significantly increased in the vicinity of interlobular pancreatic ducts, might be attributable to the presence of GCP-2.</p>

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