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From the Departments of Gastroenterology*
and
Surgery,
Pancreatic Research Group, Prince of
Wales Hospital, University of New South Wales, Sydney; and the
Department of Medicine,
Hepatic Fibrosis
Group, Clinical Sciences Unit, Queensland, Institute of Medical
Research and the University of Queensland Brisbane, Australia
The mechanisms of pancreatic fibrosis are poorly understood. In the
liver, stellate cells play an important role in fibrogenesis.
Similar cells have recently been isolated from the pancreas and are
termed pancreatic stellate cells. The aim of this study was to
determine whether pancreatic stellate cell activation occurs during
experimental and human pancreatic fibrosis. Pancreatic fibrosis was
induced in rats (n = 24) by infusion of
trinitrobenzene sulfonic acid (TNBS) into the pancreatic duct. Surgical
specimens were obtained from patients with chronic pancreatitis
(n = 6). Pancreatic fibrosis was assessed using the
Sirius Red stain and immunohistochemistry for collagen type I.
Pancreatic stellate cell activation was assessed by staining for
-smooth muscle actin (
SMA), desmin, and
platelet-derived growth factor receptor type ß (PDGFRß). The
relationship of fibrosis to stellate cell activation was studied by
staining of serial sections for
SMA, desmin,
PDGFRß, and collagen, and by dual-staining for
SMA
plus either Sirius Red or in situ hybridization for
procollagen
1 (I) mRNA. The cellular source of TGFß
was examined by immunohistochemistry. The histological appearances in
the TNBS model resembled those found in human chronic pancreatitis.
Areas of pancreatic fibrosis stained positively for Sirius Red and
collagen type I. Sirius Red staining was associated with
SMA-positive cells.
SMA staining colocalized with
procollagen
1 (I) mRNA expression. In the rat
model, desmin staining was associated with PDGFRß in areas of
fibrosis. TGFß was maximal in acinar cells adjacent to areas of
fibrosis and spindle cells within fibrotic bands. Pancreatic stellate
cell activation is associated with fibrosis in both human pancreas and
in an animal model. These cells appear to play an important role in
pancreatic fibrogenesis.
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