Detection And Significance Of Vitamin D In Alcoholic Chronic Pancreatitis

Background and aims:Alcoholic chronic pancreatitis(ACP)is a progressive inflammatory disease characterized by irreversible alterations in structures and functions.TGF-?1 and IL-6 are important inflammatory cytokines involved in persistently activation of pancreatic stellate cell(PSC).Activated PSC produces abundant extracellular matrix(ECM)and pancreatic fibrosis occurs consequently.The aim of this study was to assess the role of vitamin D(VD)in the pathogenesis of ACP and provide an experimental basis for the use of VD in ACP treatment by determination of VD level in the sera of ACP patients and analyzing the relationship between VD and TGF-?1 or IL-6 in the sera of ACP patients.Methods:The retrospective cohort study was conducted among 38 patients diagnosed with ACP in the department of Hepatic-Biliary-Pancreatic Medicine from the First Hospital of Jilin University between December 2009 and December 2019 and 30 healthy control(HC)subjects from physical examination center.Clinical data including ages,genders,alcohol consumption,serum amylases,serum lipases and images were collected.Serum samples from ACP patients were collected within 48 hours of onset and stored at-80?.The serum VD2,VD3 and T-VD levels in ACP patients and HC were determined by Liquid chromatography-tandem mass spectrometry(LC-MS/MS);The serum TGF-?1,IL-6 and Col 1?1 levels were detected with Enzyme-linked immunosorbent assay(ELISA).The relationship between T-VD and TGF-?1 or Col 1?1 was analyzed by Pearson correlation.Results:Of 38 patients(37 males,1 female),mean age was 46.0 years.All the patients exhibited the computed tomography(CT)images of ACP which included pancreatic atrophy or enlargement,irregular contour,parenchymal calcifications,pancreatic duct stones,pancreatic duct stricture or dilation,and pseudocysts.The serum VD2,VD3 and T-VD levels in ACP were lower than those in HC(P < 0.05);The serum TGF-?1,IL-6 and Col 1?1 levels in ACP were higher than those in HC(P < 0.05).Furthermore,the levels of TGF-?1 in ACP patients were positively correlated with the levels of IL-6 or Col 1?1 respectively(r=0.79,P<0.01;r=0.69,P<0.01);Whereas,the serum levels of T-VD in ACP patients were negatively correlated with TGF-?1 or Col 1?1 levels respectively(r=-0.77,P<0.01;r=-0.68,P<0.01).Conclusion:The elevation in TGF-?1 is positively correlated with increased IL-6 and Col 1?1 levels in patients with ACP;The serum VD2,VD3 and T-VD are reduced in these patients and the decreased T-VD is negatively correlated with the increased TGF-?1 or Col 1?1 respectively,suggesting that the deficiency of VD is likely to be a predisposing factor and VD supplements might act as an effective approach to inhibit pancreatic fibrosis in ACP.