RELATIONSHIP BETWEEN ERCP FINDINGS AND GLYCOPROTEIN OF PURE PANCREATIC JUICE IN ALCOHOLIC PANCREATIC DAMAGE

Focusing on the Early Stage

Abstract

The purpose of this study is to estimate the role of glycoprotein of pancreatic juice in alcoholic pancreatic damage. Pure pancreatic juice was obtained from 11 healthy controls and 30 alcoholics after secretin and pancreozymin injections by endoscopic retrograde catheterization of the papilla. Concentration of hexosamine, hexose and fucose, the main sugar components of glycoprotein, were measured as well as volume and concentration of bicarbonate, amylase and protein. After the collection of pure pancreatic juice, conventional ERCP was performed. ERCP findings of healthy controls were all normal (Control group). Alcoholics were classified into Normal group (n=11), MIP group (n=10) which has irregularly dilated side branches in more than one third of the pancreas, MOP group (n=5) and ADP group (n=4), according to the ERCP criteria of chronic pancreatitis established by Japanese Gastroenterological Association in 1983.
Exocrine pancreatic function in MIP group was considered to be normal, but hexosamine concentration of pure pancreatic juice in this group was significantly higher than that in both Control group and Normal group. This high hexosamine concentration in MIP group is though to result from hypersecretion of mucin produced from proliferated goblet cells of irregularly dilated side branches and condensation of pancreatic juice in the pancreatic ducts and ductules. Hexosamine concentration of pure pancreatic juice increased in accordance with the severity of ERCP findings. Concentration of hexose and fucose demonstrated the similar behavior as hexosamine.
It is concluded that glycoprotein of pancreatic juice plays an important role in the development of alcoholic pancreatic damage even in its early stage. Furthermore, this result suggests that the analysis of glycoprotein of pure pancreatic juice is valid for assessment of alcoholic pancreatic damage especially in its early stage.