title: Activated perilobular, not periacinar, pancreatic stellate cells contribute to fibrogenesis in chronic alcoholic pancreatitis.
abstract: The authors investigated the role of activated perilobular, not periacinar, pancreatic stellate cells, in fibrogenesis in chronic pancreatitis, based on the distribution of myofibroblasts. Twenty-four patients with clinically diagnosed chronic alcoholic pancreatitis were studied histopathologically, immunohistochemically and quantitatively. In all cases, fibrosis was patchily distributed in the perilobular, or interlobular, areas, accompanied by a cirrhosis-like appearance; it had extended into the intralobular area in advanced cases. Seven patients had a massive or confluent loss of exocrine tissue, resulting in extensive interlobular fibrosis; the more extensive the interlobular fibrosis, the smaller the lobules. Immunoreactivity to alpha-smooth muscle actin, a myofibroblast marker, was found mostly in the same areas of the fibrosis, mainly the interlobular, and less often the periacinar, areas; the average percentage area of perilobular myofibroblasts was significantly higher than that of periacinar myofibroblasts in 20 randomly selected lobules (P > 0.001), in which the average value for the former was 38.03% (range: 13.54-61.32%; SD, 13.8%) and that for the latter was 4.85% (range 0.90-9.57%; SD, 2.22%). Fibrosis also immunostained positive for collagen types I and III. In conclusion, activated perilobular, not periacinar, pancreatic stellate cell contribute to fibrogenesis in chronic pancreatitis.
authors.affiliation: Department of Pathology, Juntendo University School of Medicine, Hongo, Tokyo, Japan. ksuda@med.juntendo.ac.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Suda
authors.forename: Yuki
authors.initials: Y
authors.lastname: Fukumura
authors.forename: Masaru
authors.initials: M
authors.lastname: Takase
authors.forename: Satoko
authors.initials: S
authors.lastname: Kashiwagi
authors.forename: Motoyoshi
authors.initials: M
authors.lastname: Izumi
authors.forename: Toshio
authors.initials: T
authors.lastname: Kumasaka
authors.forename: Fujihiko
authors.initials: F
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005347:Fibroblasts / Q000473:pathology; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D032446:Myoblasts / Q000473:pathology; D010179:Pancreas / Q000473:pathology*; D019512:Pancreatitis, Alcoholic / Q000473:pathology* / Q000503:physiopathology*