Elucidation of the developmental mechanism of pancreatic acinar cell metaplasia in stomach

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K16985
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53010:Gastroenterology-related
• Research Institution: Oita University (2021-2022); Shiga University of Medical Science (2020)
• Principal Investigator: Wada Yasuhiro 大分大学, 医学部, 客員研究員 (10812125)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 膵上皮化生 / 胆汁酸逆流

Outline of Final Research Achievements

Pancreatic acinar cell metaplasia is found in gastric mucosa, and its developmental mechanism and significance are not elucidated. In this study, we created a rat reflux model of duodenal fluid. We considered that pancreatic acinar cell metaplasia is induced in the mucosa around the gastric-jejunal anastomosis, where bile acid reflux is observed, in association with gastric mucosal injury with SPEM due to duodenal fluid reflux. We also considered that pancreatic acinar cell metaplasia and pyloric metaplasia originated from stem cells derived from the neck region. The frequency of pancreatic acinar cell metaplasia in humans and the patient background of 5930 biopsies taken from the gastric mucosa showed that pancreatic acinar cell metaplasia is more likely to occur in the gastric antrum. Since the gastric antrum is a common site of bile reflux in daily practice, we hypothesized that bile acid is involved in the development of pancreatic acinar cell metaplasia.

Free Research Field

消化器内科学

Academic Significance and Societal Importance of the Research Achievements

膵上皮化生は胃粘膜に見られる化生であり、その発生メカニズムや存在意義については知られていない。本研究では膵上皮化生が十二指腸液に含まれる胆汁酸逆流により誘導されている可能性が示された。しかし、膵上皮化生を誘導する胆汁酸の同定や、実際に胃粘膜に胆汁酸刺激を加えて、膵上皮化生を誘導する遺伝子を同定できておらず今後の研究課題である。また、膵上皮化生と胃癌の発生の関与は現段階では不明であり、今後の研究課題と考える。