Characterization of endocrine progenitor cells and critical factors for their differentiation in human adult pancreatic cell culture

We have reproduced a previously described method for the in vitro generation of endocrine cells in adult human pancreatic tissue culture. The aim of this study was to characterize the nature of pancreatic progenitor cells and to identify the factors necessary for their differentiation in this model. During monolayer expansion, two types of cells proliferated sequentially; first cytokeratin 19 (CK19)-positive ductal epithelial cells and then nestin-positive fibroblastoid cells. After the bromodeoxyuridine-labeled cells were traced in differentiated islet buds, some of the proliferating ductal cells had differentiated into endocrine cells, whereas nestin-positive cells could not give rise to endocrine tissue. Serum-free culture was found to be an absolute requirement for the endocrine differentiation to occur. Also, overlay of the cells with Matrigel was essential, whereas nicotinamide had a potentiating effect. The in vitro-generated islet buds released insulin in response to glucose nearly as efficiently as native islets. When transplanted under the kidney capsule of nude mice, only one of five grafts demonstrated further growth with foci of both endocrine and exocrine differentiation. Our results support the previous notion that pancreatic progenitor cells represent a subpopulation of ductal epithelial cells. No evidence was found for the development of endocrine cells from nestin-positive stem cells.     

Human pancreatic ductal cells: large-scale isolation and expansion

The in vitro differentiation of pancreatic stem cells has recently been shown to represent a new source of beta cells for cell therapy in diabetes. Human ductal cell differentiation, in vitro, has been documented in three-dimensional (3D) culture and recently substantiated. Although encouraging, the optimization of the ductal cell source, expansion and differentiation ex vivo are mandatory for clinical relevance. We compared three sources of human ductal cells (hDC) (method A1-2, B, and C). The classical main duct isolation of hDC by explant (A1), or enzymatic digestion (A2), was compared with two indirect methods: from 3D cultured human islet/duct-enriched fractions (B) and dedifferentiated exocrine fractions (C). Method A: few viable hDC were obtained from the main duct. Method B: embedding islet/duct rich fraction in 3D collagen gels expands the cytokeratin 19 (CK19)-positive ductal component in the form of ductal cysts, as we described previously; monolayers derived from digested cysts were 80% ductal (CK19). Method C: initially adherent amylase-positive exocrine clusters contained 12% (CK19) to 22% (CK7) ductal cells. One-week exocrine cultures were amylase negative and 46% (CK19) to 63% (CK7) ductal. Cell viability varied: <20% (A1), 81+/-12% (B), 91+/-2% (C). Extrapolating total yields we obtained (+/-SEM): 10.5+/-4.6 x 10(3) (A1), 36+/-18 x 10(3) (A2), 292+/-50 x 10(6) (B), 1696+/-526 x 10(6) (C) viable hDC per pancreas. A secondary monolayer expansion of cyst-derived hDC (method B) was achieved with NuSerum (4.2-fold on plastic, 2.6-fold on 804G matrix; p < 0.05 vs. control cells on plastic). First passage exocrine-derived ductal cells also responded to matrix and to growth factors, albeit not significantly. In conclusion, this study demonstrated that an abundant hDC supply can be obtained from islet/duct or exocrine fractions followed by monolayer expansion with NuSerum. If their differentiation capacity is confirmed, in particular exocrine-derived ductal cells may represent a promising abundant source of islets for allogenic and autologous diabetes cell therapy.     

Phospholipase A2 isoforms in acute pancreatitis

OBJECTIVE: To assess phospholipase A2 isoforms during human and experimental acute necrotizing pancreatitis. Phospholipase A2 isoforms (group I, II, and IV) were examined in acute pancreatitis tissues in humans and rats to determine whether the exocrine pancreas itself is a source of these mediators. SUMMARY BACKGROUND DATA: Phospholipase A2 has important regulatory functions, especially in inflammation. METHODS: Using Northern blot analysis and immunohistochemistry, the expression and localization of phospholipase A2 isoforms were analyzed in pancreatic tissue obtained from 21 patients with acute necrotizing pancreatitis and in pancreatic tissues of rats with acute edematous and necrotizing pancreatitis. Rat samples were examined daily for 1 week. RESULTS: In human acute pancreatitis, phospholipase A2-I mRNA expression was 8.9-fold decreased. By contrast, phospholipase A2-II (7.8-fold) and phospholipase A2-IV (8.1-fold) mRNA levels were increased. By in situ hybridization, phospholipase A2-IV was found to be expressed in remaining acinar and ductal cells adjacent to the necrotic areas. Immunostaining revealed moderate to intense phospholipase A2-II immunoreactivity in remaining acinar and ductal cells next to the necrosis. In rat pancreatitis, phospholipase A2-II mRNA levels in the pancreas were unchanged in the early phase (8 hours) but markedly increased after 24 hours, with a fluctuating pattern until day 7. CONCLUSIONS: Enhanced expression of phospholipase A2-II and A2-IV isoenzymes in human and experimental acute pancreatitis suggests that these enzymes play a role in modulating the inflammatory reaction in the pancreas. Because phospholipase A2-II and A2-IV mRNA was strongly present in remaining viable pancreatic acinar and ductal cells, the pancreas itself seems to be at least partly a source and a regulator of phospholipase A2-II- and A2-IV-dependent inflammatory reactions in acute pancreatitis.     

Reproducible high yield of rat islets by stationary in vitro digestion following pancreatic ductal or portal venous collagenase injection

Pancreatic distension with collagenase solution followed by stationary in vitro digestion yields large numbers of intact islets. We compared in rats two routes of collagenase injection, pancreatic ductal (PD) and portal venous (PV), for islet yield, in vitro insulin secretory capacities, and in vivo functional viability. The islet yield in the PD method (n = 11) was greater than that in the PV method (n = 8) (682 +/- 27 vs. 417 +/- 39 per pancreas, P less than 0.025). The insulin release from the PD islets in response to 16.7 mM glucose increased gradually following culture, 3.2 +/- 0.8 ng/10 islets/30 min (fresh) to 12.3 +/- 2.1 (24-hr culture). In contrast, insulin release from the PV islets increased during the first 6 hr of culture, but decreased after 24 hr in culture. Under electronmicroscopic examination, the PD islets revealed a well preserved structure with healthy endocrine cells, while the PV islets showed a dilated capillary network and distorted endocrine cell continuity. When 100 PD islets were transplanted into streptozotocin-induced diabetic B6AF1 mice (n = 8), all the recipient mice restored normoglycemia (less than 200 mg/dl) within 1-4 days following transplantation and maintained it until rejection. However, the recipient mice given 100 PV islets showed a significant delay in restoring normoglycemia, and 3 of 8 mice given 100 PV islets were still hyperglycemic on day 4 postgrafting. In summary, pancreatic ductal collagenase injection followed by stationary in vitro digestion reproducibly yields higher numbers of intact and viable islets when compared with portal venous collagenase injection, indicating the superiority of this method to portal venous injection.     

Ductulo-insular pancreatic endocrine neoplasms: clinicopathologic analysis of a unique subtype of pancreatic endocrine neoplasms

Pancreatic neoplasms with mixed ductal and endocrine components are a heterogeneous group of tumors. The least recognized of these are pancreatic endocrine tumors (PETs) displaying benign-appearing tumor-associated ductules. To characterize these ductulo-insular pancreatic endocrine tumors (DI-PETs), we reviewed a series of 92 resected PETs. To be considered as a DI-PET we required the presence and tight intermingling of ductules with the dominant endocrine component (including the presence of ductulo-insular units). A total of 15 PETs fulfilled our criteria (16.3%). The average age of the DI-PET patients was similar to typical PETs (54 years vs 56 years). These tumors were smaller and more often insulin positive than typical PETs (p <0.05). Diffuse stromal fibrosis was more frequent in DI-PETs (11 of 15; 73.3.7%) compared with PETs (8 of 72; 11.1%) (p <0.05). The tumor-associated ductules were composed of cuboidal cells with dense eosinophilic cytoplasm and round nuclei without atypia or mitoses. They were positive for cytokeratin 7 and cytokeratin 19 and lacked any neuroendocrine markers. Reversibly, the endocrine component was negative for cytokeratin 7 and cytokeratin 19 and positive for neuroendocrine markers. Ultrastructural examination of ductulo-insular units confirmed a dual ductal and endocrine differentiation with amphicrine differentiation in one case. Follow-up was available in 12 cases with an average follow-up of 70.1 months (range 25-203 months). Ten patients are currently alive, and two patients died 81 and 158 months after surgery. We conclude that DI-PETs are not uncommon and that they are biologically similar to other PETs. We also hypothesize that the ductal cells develop by transdifferentiation of the endocrine cells.     

Improved glucose tolerance and acinar dysmorphogenesis by targeted expression of transcription factor PDX-1 to the exocrine pancreas.

The homeodomain protein PDX-1 is critical for pancreas development and is a key regulator of insulin gene expression. PDX-1 nullizygosity and haploinsufficiency in mice and humans results in pancreatic agenesis and diabetes, respectively. At embryonic day (e) 10.5, PDX-1 is expressed in all pluripotential gut-derived epithelial cells destined to differentiate into the exocrine and endocrine pancreas. At e15, PDX-1 expression is downregulated in exocrine cells, but remains high in endocrine cells. The aim of this study was to determine whether targeted overexpression of PDX-1 to the exocrine compartment of the developing pancreas at e15 would allow for respecification of the exocrine cells. Transgenic (TG) mice were generated in which PDX-1 was expressed in the exocrine pancreas using the exocrine-specific elastase-1 promoter. These mice exhibited a marked dysmorphogenesis of the exocrine pancreas, manifested by increased rates of replication and apoptosis in acinar cells and a progressive fatty infiltration of the exocrine pancreas with age. Interestingly, the TG mice exhibited improved glucose tolerance, but absolute beta-cell mass was not increased. These findings indicate that downregulation of PDX-1 is required for the proper maintenance of the exocrine cell phenotype and that upregulation of PDX-1 in acinar cells affects beta-cell function. The mechanisms underlying these observations remain to be elucidated.     

胰腺导管上皮细胞来源的胰岛样细胞移植治疗1型糖尿病

目的 观察小鼠胰腺导管上皮细胞向胰岛样细胞转分化及其在治疗糖尿病小鼠中的作用.方法 分离培养昆明小鼠胰腺导管上皮细胞,经体外扩增及诱导培养后,进行体外和体内功能评价.结果 小鼠胰腺导管上皮细胞经体外扩增和诱导分化后,逆转录-聚合酶链反应(RT-PCR)显示培养1周和2周后胰岛素mRNA的IA值为(1.892±0.119比3.135±0.092,P＜0.05),胰高血糖素为(1.564±0.087比2.271±0.042,P＜0.05),表达明显上调;胰岛样细胞对高糖刺激(15.0 mmol/L)的胰岛素释放较低糖(5.6 mmol/L)时增加了1.7倍[(52.3±10.5)mmol/L比(30.2±9.7)mmol/L,P＜0.05];DTZ染色阳性;将其移植入糖尿病小鼠体内后,移植组小鼠较对照组血糖下降,差异有统计学意义(P＜0.05).结论 昆明小鼠胰腺导管上皮细胞在体外培养条件可转分化胰岛素分泌细胞,该细胞团可在体内环境下发挥生物学功能.

Abstract：

Objective To investigate the differentiation of stem cells deived from mouse pancreatic ductal epithelial cells toward insulin secreting cells and the potential application for diabetes therapy.Methods Pancreatic ductal epithelial cells were separated and differentiated into islet-like cells. Study was performed to determine whether these islet-like clusters could secrete insulin in response to glucose both in vivo and in vitro. Results Pancreatic ductal epithelial cells were separated and cultured in vitro.The expression of insulin mRNA in the stem cells was significantly up-regulated ( 1. 892 ±0. 119 vs 3. 135± 0. 092,P ＜ 0. 05 ), and also in glucagon ( 1. 564 ± 0. 087 vs 2. 271 ± 0. 042, P ＜ 0. 05 ). Immunofluoresence staining indicated that there were a lot of insulin positive cells. Insulin released from cells in response to glucose stimulation in vitro was increased [ ( 52. 3 ± 10. 5 ) mmol/L vs ( 30. 2± 9. 7 ) mmol/L, P ＜0. 05 ]. Hyperglycemia in diabetic animals was alleviated after cell transplantation. Conclusion Islet-like cell clusters generated in vitro from Kunming mice pancreatic ductal epithelial cells could secrete insulin and have some effects on reversing the diabetes in diabetic mice.     

胰腺内分泌肿瘤中外分泌细胞成分的免疫组织化学研究

目的 探讨胰腺内分泌肿瘤中外分泌细胞成分的存在及其来源。方法 应用免疫组织化学技术（Ｓ－Ｐ法）对５７例胰腺内分泌肿瘤（非功能性胰腺内分泌肿瘤２３例,胰岛素瘤３４例）进行上皮膜抗原（ＥＭＡ）的染色,对肿瘤中外分泌细胞成分的存在和分布进行观察。结果 ２１例（３６．８％）胰腺内分泌肿瘤中具有ＥＭＡ阳性染色。阳性细胞多构成导管或腺泡样组织学结构。部分阳性细胞具有与正常外分泌细胞不一致的组织学形态和ＥＭＡ染     

Retinoid signaling directs secondary lineage selection in pancreatic organogenesis

BACKGROUND/PURPOSE: Retinoid signaling plays an important role in many differentiation pathways. Retinoid signaling has been implicated in the induction of differentiation by pancreatic ductal cancer cell lines and in patients with pancreatic cancer. The authors wished to better understand the role of retinoid signaling in pancreatic development. METHODS: Embryonic pancreas was harvested from mice at serial gestational ages and immunohistochemical analysis was performed for retinoic acid receptors (RAR-alpha, RAR-beta, RAR-gamma), and retinoid X receptors (RXR-alpha, RXR-beta, and RXR-gamma). Also, early embryonic pancreases were cultured for 7 days with exogenous 9-cis retinoic acid (9cRA) or all-trans retinoic acid (atRA) and analyzed histologically and immunohistochemically. RESULTS: Retinoid receptors were expressed in a lineage-specific distribution, with stronger expression for many in the exocrine compartment. The receptors were not often expressed until late gestation. Exogenous 9cRA induced predominantly ducts instead of acini, plus more mature endocrine (islet) architecture. Exogenous atRA induced predominantly acini instead of ducts, with no apparent endocrine effect. CONCLUSIONS: Retinoids may have an important role in pancreatic differentiation, with a particular effect on secondary lineage selection between ductal and acinar phenotype. Because the control of ductal versus acinar differentiation has been implicated strongly in the pathogenesis of pancreatic ductal carcinoma, these results may lay the groundwork for studies in the mechanism of induced differentiation of pancreatic ductal cancer by retinoids.     

从人胚胎胰腺中分离获得巢蛋白表达阳性的细胞

目的 探讨从人胚胎胰腺组织分离巢蛋白（Nestin)阳性细胞并进行体外传代培养的方法。方法 取引产的16、18、20周人胚胎胰腺组织，分离胰岛样细胞簇（Ialet-like cell clusters,ICCs），进行体外培养。用免疫组织化学和逆转录-聚合酶链反应（RT-PCR）方法检测巢蛋白、胰十二指肠同源盒基因-1（Pancreatic and duodenal bomeobox gene-1,PDX-1/IPF-1)以及胰岛内分泌激素胰岛素和胰升糖素（Glucagon)的表达。结果 ICCs经体外培养可获得巢蛋白表达阳性细胞，这种细胞可进一步形成球状细胞簇，除有巢蛋白阳性细胞外，还有PDX-1，胰岛素和胰升糖素表达阳性的细胞。并且细胞可连续传代，结论 从人胚胎胰腺组织中可分离获得巢蛋白表达阳性细胞，这种细胞可在体外增殖并有向胰岛内分泌细胞分化的能力。     

Combination therapy with glucagon-like peptide-1 and gastrin induces beta-cell neogenesis from pancreatic duct cells in human islets transplanted in immunodeficient diabetic mice

Pancreatic islet transplantation as a treatment for type 1 diabetes is limited by human donor tissue availability. We investigated whether the beta-cell mass in human isolated islets could be expanded by treatments with glucagon-like peptide-1 (GLP-1) and gastrin, peptides reported to stimulate beta-cell growth in mice and rats with deficits in beta-cell mass. Human islets with low endocrine cell purity (7% beta-cells, 4% alpha-cells) and abundant exocrine cells (29% duct cells and 25% acinar cells) were implanted under the renal capsule of nonobese diabetic-severe combined immune deficiency (NOD-scid) mice made diabetic with streptozotocin. The mice were treated with GLP-1 and gastrin, separately and together, daily for 5 weeks. Blood glucose was significantly reduced only in mice implanted with human pancreatic cells and treated with GLP-1 plus gastrin. Correction of hyperglycemia was accompanied by increased insulin content in the human pancreatic cell grafts as well as by increased plasma levels of human C-peptide in the mice. Immunocytochemical examination revealed a fourfold increase in insulin-positive cells in the human pancreatic cell grafts in GLP-1 plus gastrin-treated mice, and most of this increase was accounted for by the appearance of cytokeratin 19-positive pancreatic duct cells expressing insulin. We conclude that combination therapy with GLP-1 and gastrin expands the beta-cell mass in human islets implanted in immunodeficient diabetic mice, largely from pancreatic duct cells associated with the islets, and this is sufficient to ameliorate hyperglycemia in the mice.     

Distribution of Ia-positive cells in the pig and human pancreas

With monoclonal antibody reacting with both human and porcine Ia antigens, we demonstrate with immunoperoxidase staining that Ia expressing endothelial cells are found in Langerhans' islets as well as in exocrine tissue of the pig and human pancreas. However, neither endocrine cells in Langerhans' islets nor acinar or ductal cells do express the Ia antigen.     

成人胰腺干细胞转分化为胰岛的研究

目的：通过对成人胰腺干细胞转分化为胰岛过程的研究以便更深入了解及改进胰腺干细胞分离、培养、鉴定方法。方法：成人胰腺组织经胶原酶消化后,用密度梯度离心法将胰腺外分泌细胞、导管上皮细胞和胰岛分离、纯化,导管上皮细胞即具有转分化潜能的干细胞,在体外先后以CMRL1066和无血清DMEM／F12培养液共培养27d,在培养的不同时间点取样本于光镜和电镜下观察细胞形态学变化及干细胞特异性转录基因PDX－1,CK－19蛋白等单抗的免疫组化染色,并测定培养液中的淀粉酶和胰岛素含量。结果：上述方法可获得大量以往在胰岛分离时丢弃的胰腺导管上皮细胞。经体外一定条件的培养后,第1天即可见PDX－1,CK－19阳性细胞,胰腺导管上皮细胞迅速分裂增殖并转变为有分化能力的干细胞继而转分化为三维结构的胰岛细胞。培养27d后,平均每克胰腺组织可生成760个胰岛。结论：成人胰腺的导管上皮具有干细胞潜能并可在体外转分化为大量具有内分泌功能的胰岛,用此方法获得大量的胰岛可能为克服胰岛移植的供体短缺提供一条新的途径。