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The Clinical Study of IgG4 Associate Pancreatitis (Autoimmune Pancreatitis) and Development of its Diagnostic System

Research Project

Project/Area Number 13557047
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section展開研究
Research Field Gastroenterology
Research InstitutionShinshu University

Principal Investigator

KAWA Shigeyuki  Shinshu University School of Medicine, Associate Professor, 医学部, 助教授 (10177628)

Project Period (FY) 2001 – 2003
Project Status Completed (Fiscal Year 2003)
Budget Amount *help
¥14,200,000 (Direct Cost: ¥14,200,000)
Fiscal Year 2003: ¥2,000,000 (Direct Cost: ¥2,000,000)
Fiscal Year 2002: ¥2,000,000 (Direct Cost: ¥2,000,000)
Fiscal Year 2001: ¥10,200,000 (Direct Cost: ¥10,200,000)
Keywordsautoimmune pancreatitis / IgG4 / pancreatic cancer / sclerosing cholangitis / retroperitoneal fibrosis / HLA / superoxide dismutase 2 / lgG4 / 甲状腺機能低下症 / 胃潰瘍 / 疾患感受性遺伝子 / 後腹膜繊維症
Research Abstract

The present study revealed that autoimmune pancreatitis is characterized by elderly male preponderance and obstructive jaundics as an initial symptome. Sometimed it is difficult to differentiate this disease from pancreatic cancer clinically, but serum IgG4 measurement is useful tool for differentiation. Significant changes of pancreatigram in follow-up study showed the diversity of clinical features of this disease. We found low frequency of authentic autoantibodies, such as SS-A, SS-B and anti-mitochondrial antibody in this disease. We found anti-alfa-fodrin antibody in sera of autoimmune pancreatitis patients with sclerosing cholangitis, suggesting that this antibody is associated the formation of such an extra-pancreatic lesion.
Auotimmune pancreatitis is characterized by co-occurrence of various exta-pancreatic lesions._The present study showed hilar lesions by gallium-67 scintigrphy and retroperitoneal fibrosis, suggesting that this disease is regarded as systemic disease, such as multifocal fibrosclerosis. The autoimmune pancreatitis is significantly associated with HLA DRB1*0405-DQB1*0401 haplotype, which may present specific antigen peptide to T cells, resulting in the initiation of autoi, mmune response.
The present study revealed that sera of the patient with this disease react specifically to 25 kDa band, which was later confirmed as superoxide dismutase 2 (SOD2). In many autoimmune diseases, autoantibodies react to SOD2, suggesting the candidate of target antigen. However, recombinant SOD2 protein could not react with patient sera. We should perform further study to confirm whether glucoconjugate portion of this protein is antigen determinant.

Report

(4 results)
  • 2003 Annual Research Report   Final Research Report Summary
  • 2002 Annual Research Report
  • 2001 Annual Research Report
  • Research Products

    (54 results)

All Other

All Publications (54 results)

  • [Publications] Horiuchi A: "Sclerosing pancreato-cholangitis responsive to corticosteroid therapy : report of 2 case reports and review."Gastrointest Endosc. 53. 603-608 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 川 茂幸: "膵管挟細型膵炎における免疫学的検討-IgG4の関与を中心として-"胆と膵. 22. 603-608 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 浜野英明: "自己免疫性膵炎をめぐる最近の話題-免疫生化学検査-"肝胆膵. 43. 225-231 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 金児猛夫: "糖尿病で現れた自己免疫性膵炎の1例"Endoscopic Forum. 17. 68-74 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Hamano, H: "Sclerosing pancreatitis complicated with hydronephrosis caused by retroperitoneal fibrosis"Lancet. 359. 1403-1404 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Kawa S: "HLA DRB1*0405-DQB1*0401 haplotype is associated with autoimmune pancreatitis in the Japanese population."Gastroenterology. 122. 1264-1269 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Horiuchi A: "Does a lack of reactivity to a-fodrin indicate the existence of primary autoimmunepancreatitis"Am J Gastroenterol. 97. 1275-1277 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Horiuchi A: "ERCP features in 27 patients with autoimmune pancreatitis"Gastrointest Endosc. 55. 494-499 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Akahane C: "A primary Sjoegren's syndrome patient presenting marked swelling of multiple exocrine glands and sclerosing pancreatitis"Internal Medicine. 41. 749-753 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 川 茂幸: "自己免疫性膵炎"信州医学雑誌. 50. 233-240 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 川 茂幸: "自己免疫性膵炎診断基準の解説 2.血清学的診断"膵臓. 17. 607-610 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Saegusa H: "Hilar and pancreatic gallium-67 accumulation is characteristic feature of autoimmune pancreatitis"Pancreas. 27. 20-25 (2003)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Kawa S: "Autoimmune pancreatitis and bile duct lesions"J Gastroenterol. 38. 1201-1203 (2003)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Takayama M: "Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation"Am J Gastroenterol. (in press).

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Shinji A: "Autoimmune Pancreatitis is Closely Associated with Gastric Ulcer Presenting with Abundant IgG4-bearing Plasma Cell Infiltration"Gastrointest Endosc. (in press).

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 川 茂幸: "自己免疫性膵炎の診断と治療"日本医事新報. 4143. 8-13 (2003)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 川 茂幸: "自己免疫性膵炎の臨床"ENDOSCOPIC FORUM for digestive disease. 19. 149-157 (2003)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 小松健一: "膵尾部癌との鑑別が困難であった自己免疫性膵炎の一例"肝胆膵. 47. 985-991 (2003)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 小松健一: "自己免疫性膵炎の経過観察中に膵管内結石を発症し体外衝撃波破砕療法を施行した一例"膵臓. 18. 489-494 (2003)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 浜野英明: "自己免疫性膵炎-概念と病態up-to-date、病態生理、A 臨床面よりの検討、d 自己免疫現象よりみた検討"診断と治療社. 179(48-55) (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 堀内 朗: "自己免疫性膵炎-概念と病態up-to-date-、合併症・随伴疾患 B 胆管病変(3)、-硬化性胆管炎を合併した自己免疫性膵炎-"診断と治療社. 179(109-114) (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] 浜野英明: "自己免疫性膵炎-概念と病態up-to-date-、症例呈示(4)、-IgG4関連膵炎(IgG4関連膵胆管炎)の再燃症例の呈示"診断と治療社. 179(143-150) (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Horiuchi A, et al.: "Sclerosing pancreato-cholangitis responsive to corticosteroid therapy : report of 2 case reports and review"Gastrointest Endosc. 53. 518-522 (2001)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Hamano H, et al.: "Sclerosing pancreatitis complicated with hydronephrosis caused by retroperitoneal fibrosis"Lancet.. 359. 1403-1404 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Kawa S, et al.: "HLA DRB1^*0405-DQB1^*0401 haplotype is associated with autoimmune pancreatitis in the Japanese population"Gastroenterology.. 122. 1264-1269 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Horiuchi A, et al.: "Does a lack of reactivity to a-fodrin indicate the existence of primary autoimmunepancreatitis"Am J Gastroenterol.. 97. 1275-1277 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Horiuchi A, et al.: "ERCP features in 27 patients with autoimmune pancreatitis"Gastrointest Endosc. 55. 494-499 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Akahane C, et al.: "A primary Sjoegren's syndrome patient presenting marked swelling of multiple exocrine glands and sclerosing pancreatitis"Internal Medicine. 41. 749-753 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Saegusa H, et al.: "Hilar and pancreatic gallium-67 accumulation is characteristic feature of autoimmune pancreatitis"Pancreas. 27. 20-25 (2003)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Kawa S, et al.: "Autoimmune pancreatitis and bile duct lesions"J Gastroenterol. 38. 1201-1203 (2003)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Takayama M, et al.: "Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation."Am J Gastroenterol. (in press).

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Shinji A, et al.: "Autoimmune Pancreatitis is Closely Associated with Gastric Ulcer Presenting with Abundant IgG4-bearing Plasma Cell Infiltration"Gastrointest Endosc. (in press).

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2003 Final Research Report Summary
  • [Publications] Saegusa H: "Hilar and pancreatic gallium-67 accumulation is characteristic feature of autoimmune pancreatitis"Pancreas. 27. 20-25 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] Kawa S: "Autoimmune pancreatitis and bile duct lesions"J Gastroenterol. 38. 1201-1203 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] Takayama M: "Recurrent attacks of autoimmune pancreatitis result in pancreatic stone formation"Am J Gastroenterol. (in press).

    • Related Report
      2003 Annual Research Report
  • [Publications] Shinji A: "Autoimmune Pancreatitis is Closely Associated With Gastric Ulcer Presenting with Abundant IgG4-bearing Plasma Cell Infiltration"Gastrointest Endosc. (in press).

    • Related Report
      2003 Annual Research Report
  • [Publications] 川 茂幸: "自己免疫性膵炎の診断と治療"日本医事新報. 4143. 8-13 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] 川 茂幸: "自己免疫性膵炎の臨床"ENDOSCOPlC FORUM for digestive disease. 19. 149-157 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] 小松健一: "膵尾部癌との鑑別が困難であった自己免疫性膵炎の一例"肝胆膵. 47. 985-991 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] 小松健一: "自己免疫性膵炎の経過観察中に膵管内結石を発症し体外衝撃波破砕療法を施行した一例"膵臓. 18. 489-494 (2003)

    • Related Report
      2003 Annual Research Report
  • [Publications] Hamano, H: "Sclerosing pancreatitis complicated with hydronephrosis caused by retroperitoneal fibrosis"Lancet. 359. 1403-1404 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Kawa, S: "HLA DRB1^*0405-DQB1^*0401 haplotype is associated with autoimmune pancreatitis in the Japanese population"Gastroenterology. 122. 1264-1269 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Horiuchi, A.: "Does a lack of reactivity to a-fodrin indicate the existence of primary autoimmunepancreatitis"Am J Gastroenterol. 97. 1275-1277 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Horiuchi A: "ERCP features in 27 patients with autoimmune pancreatitis"Gastrointest Endosc. 55. 494-499 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Akahane, C: "A primary Sjoegren's syndrome patient presenting marked swelling of multiple exocrine glands and sclerosing pancreatitis"Internal Medicine. 41. 749-753 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] 川 茂幸: "自己免疫性膵炎"信州医学雑誌. 50. 233-240 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] 川 茂幸: "自己免疫性膵炎診断基準の解説2.血清学的診断"膵臓. 17. 607-610 (2002)

    • Related Report
      2002 Annual Research Report
  • [Publications] Hamano.H. Kawa, S. et al.: "Scierosing pancreatitis complicated with hydronephrosis caused by retroperitoneal fibrosis"Lancet.. (in press).

    • Related Report
      2001 Annual Research Report
  • [Publications] Kawa, S. Ota.M. et al.: "HLA DRB^1*O4O5DQB1^*0401 haplotype is associated with autoimmune pancreatitis in the Japanese population"Gastroenterology. (in press).

    • Related Report
      2001 Annual Research Report
  • [Publications] Horiuchi.A. Kawa.S. et al.: "Does a lack of reactivity to a-f drin indicate the existence of primary autoimmunepancreatitis"Am J Gastroenterol.. (in press).

    • Related Report
      2001 Annual Research Report
  • [Publications] Horiuchi.A. Kawa.S. et al.: "ERCP features in 27 patients with autoimmune pancreatitis"Gastrointest Endosc. (in press).

    • Related Report
      2001 Annual Research Report
  • [Publications] Kawa S. et al.: "Growth inhibition and differentiation of pancreatic cancern cell lines by PPAR γ ligand troglitazone"Pancreas. 24. 1-7 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] Aoki Y. Hosaka S. Kawa S. et al.: "Potential tumor-targeting peptide vector of histidylated oligolysine conjugated to a tumor-homino RGD motif"Cancer Gene Therapy. 8. 783-787 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] Kawa S. Kiyosawa K: "Growth inhibition of pancreatic cancer cell lines by ligand activation of nuclear hormone receptors through up-expression of WAF1/CIP1/p21 ; in Trends in Gastroenterology and Hepatology"Springer-Verlag Tokyo. (2001)

    • Related Report
      2001 Annual Research Report

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Published: 2001-04-01   Modified: 2016-04-21  

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