T1384 Smoking Induces Pancreatic Fibrosis in Humans

Introduction Smokers are at risk for pancreatic cancer and other pancreatic diseases. Cigarette smoking also aggravates the risk of pancreatic cancer in patients with hereditary and chronic pancreatitis and results in a higher incidence of acute pancreatitis and relapses in chronic pancreatitis. Both pancreatic cancer and chronic pancreatitis are characterized by a progressive fibrosis. Recently, two studies on rats reported that tobacco smoking is associated with chronic pancreatic inflammation with fibrosis, and scarring of pancreatic acinar structures. In this study we aim to confirm a relation between cigarette smoking and pancreatic fibrosis (PF) in humans. Methods In this retrospective study, pancreatic tissue acquired during autopsy was collected and revised. Pancreatic fibrosis (PF) was gradually scored by analyzing intra-lobular, extra-lobular and total PF: grade 0 (normal or mild; 0-25% PF), grade 1 (moderate; 25-50%PF), grade 2 (severe; >50%). Information on smoking habits was extracted from (electronic) medical files. Results Of 900 autopsies, performed from January 2005 till December 2007, the minority of available histology material (n=111) was of significant quality to be included for analysis. Grade 2-3 total PF and intra-lobular PF was significantly more present in “smokers” versus “never smokers” (total: 42.9% vs 26.5%, p=0,027 and intra-lobular: 39.3% vs 15.6%, p=0.013), whereas no differences could be found between “never smokers” and “abstinent smokers” and “abstinent smokers” and “smokers”. When taking into account interlobular PF, no differences between all groups were observed. Conclusion To date no human study studied the effect of tobacco smoking on pancreatic tissue. We demonstrate for the first time that current cigarette smoking is associated with total pancreatic fibrosis and more specific intra-lobular pancreatic fibrosis, compared to non-smokers.