Reduced pancreatic volume and beta-cell area in patients with chronic pancreatitis.
OBJECTIVE
Chronic pancreatitis (CP) often leads to the development of diabetes. To understand better this pathogenic mechanism, we investigated whether islet cell area and pancreatic volume are reduced in CP patients, islet cell turnover increases in CP patients, and islet cells are less vulnerable to apoptosis than acinar cells.


METHODS
Pancreatic tissues from 43 patients with CP and 27 controls were examined by immunohistochemistry and quantitative morphometry. Pancreas volume was determined using abdominal computed tomography data.


RESULTS
The pancreatic volumes were 64.9 +/- 4.3 cm(3) in CP patients and 82.3 +/- 6.7 cm(3) in controls (P = .035). beta-cell areas were 0.69% +/- 0.08% in CP patients and 0.97% +/- 0.08% in controls (P = .017), whereas alpha-cell areas did not differ between the groups (P = .47). There were no differences in the frequencies of replication among groups of alpha-cells, beta-cells, duct cells, or acinar cells nor were there differences in numbers of apoptotic alpha-cells or beta-cells between CP patients and controls. However, CP patients had an approximately 10-fold increase in numbers of apoptotic acinar cells compared with controls (P < .0001).


CONCLUSIONS
Pancreatic volume was reduced by 21%, and the area comprising beta-cells was reduced by 29% in patients with CP. The lack of increased beta-cells turnover in CP patients, despite an approximately 10-fold increase in the number of apoptotic acinar cells, suggests that the damage to the pancreas is highly specific for the exocrine compartment and affects the endocrine islets to a lesser extent.
Schrader
Henning
H
Department of Medicine I, St. Josef-Hospital, Ruhr-University Bochum, Germany.
Menge
Bjoern A
BA
Schneider
Simone
S
Belyaev
Orlin
O
Tannapfel
Andrea
A
Uhl
Waldemar
W
Schmidt
Wolfgang E
WE
Meier
Juris J
JJ
D000328:Adult; D000368:Aged; D017209:Apoptosis; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D050417:Insulin-Secreting Cells / Q000000981:diagnostic imaging / Q000473:pathology*; D007515:Islets of Langerhans / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology*; D050500:Pancreatitis, Chronic / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed