? I am a physician scientist interested in the molecular & cellular mechanisms of acute pancreatitis (AP). My short term career goal is to use a mouse model of CF to investigate why humans with atypical CF develop recurrent AP, findings which may lead to disease prevention & effective treatments. This project features mentorship by Dr. Owyang & my scientific advisory committee and a career development program which will ensure successful R01 funding & development as an independent investigator within 3-4 years. ? CFTR gene mutations are found in 17-38% of patients with idiopathic recurrent AP, an atypical CF phenotype. Preliminary data provided the novel findings that CF mice induced with AP develop more severe injury associated with an anti-apoptotic acinar cell response and exuberant pancreatic inflammation. Because pancreatic acinar cell expression of CFTR is weak and of doubtful functional significance, I investigated extra-acinar triggers to explain the acinar anti-apoptotic phenotype. Expression and function of the anti-apoptotic acinar Na+/H+ exchanger (NHE-1) is important because in both CF mice and human CF, the inter-acinar space and lumen of ductules is acidic, and extracellular acidity activates NHE-1. Preliminary studies showed that NHE-1 protein was overexpressed in CF mouse pancreas and that NHE-1 pharmacologic inhibition or genetic deletion in wild-type mice reduced the severity of AP and was associated with increased markers of acinar cell apoptosis. I hypothesized that the susceptibility of CF mice to more severe AP and atypical human CF to recurrent AP is attributable to pancreatic acinar cell resistance to apoptosis because of acinar NHE-1 activation. I propose 1) to determine the individual contribution of CF acinar cells to the anti-apoptotic, proinflammatory phenotype; 2) to delineate the pro- & anti-apoptotic proteins responsible for the anti-apoptotic phenotype in CF mice during AP; and 3) to determine whether the severity of AP is attenuated & coupled to increased apoptosis by inhibiting or deleting NHE-1. ? Acute pancreatitis (AP) is associated with considerable morbidity & mortality, leading to 3200 deaths and 300,000 hospitalizations annually in the USA, costing more than $2 billion. Understanding of the pathophysiology of AP is incomplete & therapies are lacking. The proposed study may provide insight into the pathogenesis of AP & CF & contribute to generation of novel therapies. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Clinical Investigator Award (CIA) (K08)
Project #
1K08DK073298-01A1
Application #
7147051
Study Section
Diabetes, Endocrinology and Metabolic Diseases B Subcommittee (DDK)
Program Officer
Podskalny, Judith M,
Project Start
2006-07-01
Project End
2011-06-30
Budget Start
2006-07-01
Budget End
2007-06-30
Support Year
1
Fiscal Year
2006
Total Cost
$132,300
Indirect Cost
Name
University of Michigan Ann Arbor
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
073133571
City
Ann Arbor
State
MI
Country
United States
Zip Code
48109
Dimagno, Matthew J; Wamsteker, Erik-Jan; Rizk, Rafat S et al. (2014) A combined paging alert and web-based instrument alters clinician behavior and shortens hospital length of stay in acute pancreatitis. Am J Gastroenterol 109:306-15
DiMagno, Matthew J; Spaete, Joshua P; Ballard, Darren D et al. (2013) Risk models for post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP): smoking and chronic liver disease are predictors of protection against PEP. Pancreas 42:996-1003
DiMagno, Matthew J; DiMagno, Eugene P (2012) Chronic pancreatitis. Curr Opin Gastroenterol 28:523-31
DiMagno, Matthew J; Dimagno, Eugene P (2012) Pancreas divisum does not cause pancreatitis, but associates with CFTR mutations. Am J Gastroenterol 107:318-20
DiMagno, Matthew J; DiMagno, Eugene P (2011) Chronic pancreatitis. Curr Opin Gastroenterol 27:452-9
Radtke, Andrea L; Anderson, Kelsi L; Davis, Michael J et al. (2011) Listeria monocytogenes exploits cystic fibrosis transmembrane conductance regulator (CFTR) to escape the phagosome. Proc Natl Acad Sci U S A 108:1633-8
DiMagno, Matthew J; Wamsteker, Erik-Jan (2011) Pancreas divisum. Curr Gastroenterol Rep 13:150-6
DiMagno, Matthew J; Lee, Sae-Hong; Owyang, Chung et al. (2010) Inhibition of acinar apoptosis occurs during acute pancreatitis in the human homologue DeltaF508 cystic fibrosis mouse. Am J Physiol Gastrointest Liver Physiol 299:G400-12
Waljee, A K; Dimagno, M J; Wu, B U et al. (2009) Systematic review: pancreatic enzyme treatment of malabsorption associated with chronic pancreatitis. Aliment Pharmacol Ther 29:235-46
Debenedet, Anthony T; Raghunathan, Trivellore E; Wing, Jeffrey J et al. (2009) Alcohol use and cigarette smoking as risk factors for post-endoscopic retrograde cholangiopancreatography pancreatitis. Clin Gastroenterol Hepatol 7:353-8e4

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