Nesidioblastosis and endocrine hyperplasia of the pancreas: A secondary phenomenon

Goudswaard, Willem B.; Houthoff, H. J.; Koudstaal, J.; Zwierstra, R. P.

doi:10.1016/s0046-8177(86)80154-x

Cited by 65 publications

(41 citation statements)

References 15 publications

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“…Ductal epithelial cells have been demonstrated to give rise to islet tissue in various experimental models of pancreas regeneration (5-7). Ductal origin of neogenic islets is also suggested by morphologic observations in human tissue (31,32) and in clinical pathologies (33). Another type of tissue stem cell was reported in the rat pancreas to consist of a distinct population of cells expressing the neural stem cell marker nestin (11,12).…”

Section: Discussionmentioning

confidence: 92%

Characterization of Endocrine Progenitor Cells and Critical Factors for Their Differentiation in Human Adult Pancreatic Cell Culture

et al. 2003

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Section: Discussionmentioning

confidence: 92%

Characterization of Endocrine Progenitor Cells and Critical Factors for Their Differentiation in Human Adult Pancreatic Cell Culture

et al. 2003

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“…In both rodents and humans, immunohistochemical studies have demonstrated that this common differentiating progenitor cell is ductal in phenotype (cytokeratin -or CK19-positive) (3,4). In the adult pancreas, endocrine cell formation from ductal epithelial cells can be observed both in experimental models of pancreatic regeneration (5) and in various clinical pathologies (6). Islet differentiation from murine pancreatic ductal stem cells in vitro has recently been achieved (7).…”

mentioning

confidence: 99%

Adult human cytokeratin 19-positive cells reexpress insulin promoter factor 1 in vitro: further evidence for pluripotent pancreatic stem cells in humans.

et al. 2000

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Human pancreatic cells with a typical ductal phenotype and potential to proliferate can be obtained in vitro, but the differentiation capacity of these putative human pancreatic stem cells remains to be documented. We investigated the protein and mRNA expression of insulin promoter factor 1 (IPF-1) (or pancreas/duodenal homeobox 1), a transcription factor critical for pancreatic development and endocrine cell neogenesis, in human pancreatic ductal cells derived from cultured exocrine tissue. In vitro, exocrine cells rapidly adhered (within 12 h) and were de-/transdifferentiated to ductal cells after 3 days with a dramatic loss of amylase protein (n = 4, 92 ± 3.3%, P < 0.05 vs. day 1) and a simultaneous increase of ductal cytokeratin 19 protein (n = 4, 3.4-fold on day 3 and 7-fold on day 9, P < 0.05 vs. day 1). IPF-1 protein and mRNA levels were low to undetectable in exocrine preparations before culture. After 2 days of culture, a 3.2-fold increase in IPF-1 protein was observed, corresponding to the characteristic 46-kDa protein in Western blots. Reverse transcriptase-polymerase chain reaction confirmed a 10.5-fold increase in IPF-1 mRNA levels after 3 days of culture (n = 5, P < 0.001 vs. day 1). Double immunocytochemistry showed direct evidence that IPF-1 appeared during culture in these exocrine-derived ductal cells (cytokeratin 7-positive) and was not merely in contaminating endocrine cells (chromogranin A-positive).In conclusion, we describe herein the first converging evidence on both the molecular and protein level that human cells with a typical ductal phenotype derived ex vivo from pancreatic exocrine tissue (obtained from healthy donors) can reexpress IPF-1 in culture, suggesting their pancreatic precursor/stem cell potential.

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“…The histopathology of HI is heterogeneous and is hallmarked by the presence of ducto-endocrine proliferation, supernumerary small endocrine groups, and large endocrine areas [11]. Broadly, on histopathology, there are two forms of HI: the focal form (FoHI), which comprises about 30 % of cases, and the diffuse form (DiHI), which comprises about 70 % of cases.…”

Section: Discussionmentioning

confidence: 99%

Subtotal Pancreatectomy for Congenital Hyperinsulinism: Our Experience and Review of Literature

et al. 2013

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Congenital hyperinsulinism (HI) is characterized by profound hypoglycemia caused by inappropriate insulin secretion. HI is a heterogeneous disorder with at least two histologic lesions and several implicated genes. If HI is caused by a focal lesion, elective surgery is the treatment of choice because it leads to complete recovery without diabetes. On the contrary, near-total pancreatectomy though recommended for diffuse HI, long-term risks of endocrine and exocrine deficiencies are present. Between the years 2006-2011, three patients of HI were referred to and operated by a single surgeon. The preoperative diagnosis was confirmed by recurrent hypoglycemia, inappropriately high insulin levels, and augmented glucose requirements. The medical records of all three patients were reviewed to study their clinical features, medical and surgical treatment, and postoperative outcome (short-and long-term). There were three patients in this series (male/female ratio, 1:2), all presenting in the neonatal age. All patients failed medical treatment, and radiological imaging did not reveal any pancreatic lesion. All patients underwent subtotal (80 %) pancreatectomy. Two patients had diffuse type of HI and one focal HI. One patient had transient hyperglycemia for 3 months, which needed insulin supplementation. No patient has developed recurrent hypoglycemia, malabsorption syndrome, or any neurological sequelae until the last followup. Doing subtotal or near-total pancreatectomy in diffuse type of HI still remains controversial as one has a higher risk of recurrent hypoglycemia, while the other has a higher rate of insulin dependent diabetes mellitus. Subtotal (80 %) pancreatectomy may be considered as the primary modality of surgical intervention in diffuse type of HI, especially when the diagnostic facilities are limited or diagnosis is not known after preliminary investigations. This minimizes the chances of postoperative diabetes mellitus, and redo surgery can always be considered if there is recurrent hypoglycemia.

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Nesidioblastosis and endocrine hyperplasia of the pancreas: A secondary phenomenon

Cited by 65 publications

References 15 publications

Characterization of Endocrine Progenitor Cells and Critical Factors for Their Differentiation in Human Adult Pancreatic Cell Culture

Characterization of Endocrine Progenitor Cells and Critical Factors for Their Differentiation in Human Adult Pancreatic Cell Culture

Adult human cytokeratin 19-positive cells reexpress insulin promoter factor 1 in vitro: further evidence for pluripotent pancreatic stem cells in humans.

Subtotal Pancreatectomy for Congenital Hyperinsulinism: Our Experience and Review of Literature

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