Emerging research indicates that vitamin D metabolic disorder plays a major role in both acute pancreatitis (AP) and chronic pancreatitis (CP). This has been demonstrated by studies showing that vitamin D deficiency is associated with pancreatitis and its anti-inflammatory and anti-fibrotic effects by binding with the vitamin D receptor (VDR). However, the role of vitamin D assessment and its management in pancreatitis remains poorly understood. In this narrative review, we discuss the recent advances in our understanding of the molecular mechanisms involved in vitamin D/VDR signaling in pancreatic cells; the evidence from observational studies and clinical trials that demonstrate the connection among vitamin D, pancreatitis and pancreatitis-related complications; and the route of administration of vitamin D supplementation in clinical practice. Although further research is still required to establish the protective role of vitamin D and its application in disease, evaluation of vitamin D levels and its supplementation should be important strategies for pancreatitis management according to currently available evidence.

Chaiqinchengqi decoction, a traditional Chinese medicine, has shown promising effects in in vitro, animal and preliminary small human studies for acute pancreatitis, but evidence of clinical practice is limited. To investigate whether Chaiqinchengqi decoction could improve clinical outcomes in patients with acute pancreatitis. Prospective, pragmatic, randomized controlled trial. (Chictr.org.cn registration number: ChiCTR2000034325) METHODS: This trial was conducted at West China Hospital of Sichuan University, China. Patients with acute pancreatitis were randomly assigned to receive either Chaiqinchengqi decoction or placebo by oral and rectal enemas in addition to guideline-directed administrations using a 1:1 ratio. The intervention of Chaiqinchengqi and placebo was determined by the grading of acute gastrointestinal injury. Patients were assessed within 24 and 48 hours, and on 3, 5, and 7 days after admission, or organ failure normalized. Survivors were followed up at 1, 3, and 6 months after discharge. Primary outcome was the duration of respiratory failure to 28 days after enrollment. Secondary outcomes included other organ failure, local complications, 6-month all-cause mortality, inflammatory indicators, and related interventions. Among 248 patients enrolled, Chaiqinchengqi decoction shortened the duration of respiratory failure compared with the placebo (median [IQR], 1.0 [0.0 to 5.0] vs 3.0 [1.0-8.0] days; median difference, -1.0; 95% CI, -2.0 to 0.0, P=.001). There were significant differences in the duration of circulatory failure, the incidence of new-onset respiratory and cardiovascular and failure, the incidence of new organ failure, severity, intensive care unit need, pain visual analogue scale, pancreatitis activity scoring system, and EQ-5D-5L. Chaiqinchengqi decoction as an adjunctive therapy significantly reduced the duration of respiratory failure and improved 6-month clinical outcomes of acute pancreatitis in addition to guideline-directed treatments. Further study is needed to elucidate the mechanism of action.

Pancreatic cancer (PC), one of the most aggressive malignancies, is characterized by a dismal prognosis owing to its low early detection rates, rapid progression, frequent postoperative complications, and limited efficacy of conventional oncological therapies. The fact that most patients are diagnosed at advanced stages underscores the critical importance of early detection for the formulation of effective treatment strategies. Despite substantial research efforts, the medical community still lacks consistent and dependable biomarkers for the diagnosis, classification, and prognosis of PC, highlighting the urgent need for innovative and more efficient approaches to identify pancreatic abnormalities at early stages. For decades, mass spectrometry (MS)-based proteomics has been extensively applied in disease diagnostics, mechanistic investigations, and screening of potential drug targets. This review systematically synthesizes recent advancements in clinical proteomic techniques and applications, highlighting significant biomarker discoveries and signal transduction networks associated with PC. By integrating these findings, we provide novel insights into the molecular mechanisms underlying PC development and progression, which may facilitate the identification of new diagnostic biomarkers and therapeutic targets for this disease.

Background: Acute pancreatitis (AP) is a common digestive disease with increased incidence globally but without internationally licenced pharmacological therapy. Moderately severe and severe acute pancreatitis (MSAP/SAP) contributes predominately for its morbidities and mortality and has been managed in West China Hospital for decades using the traditional Chinese medicinal formula chaiqin chengqi decoction (CQCQD). The current study tests whether the early administration of CQCQD will result in improved clinical outcomes in predicted MSAP/SAP patients. Methods: This is a single-centre, randomised, controlled, double-blind pragmatic clinical trial. AP patients aged 18–75 admitted within 72 h of onset will be assessed at admission for enrolment. We excluded the predicted mild acute pancreatitis (Harmless Acute Pancreatitis Score > 2 at admission) and severe organ failure (Sequential Organ Failure Assessment [SOFA] score of respiratory, cardiovascular, or renal systems > 3) at admission. Eligible patients will be randomly allocated on a 1:1 basis to CQCQD or placebo control administration based on conventional therapy. The administration of CQCQD and placebo is guided by the Acute Gastrointestinal Injury grade-based algorithm. The primary outcome measure will be the duration of respiratory failure (SOFA score of respiratory system ≥ 2) within 28 days after onset. Secondary outcome measures include occurrence of new-onset any organ failure (SOFA score of respiratory, cardiovascular, or renal system ≥ 2) and new-onset persistent organ failure (organ failure lasts > 48 h), dynamic surrogate biochemical markers and clinical severity scores, gut-centred treatment modalities, local complications status, intensive care need and duration, surgical interventions, mortality, and length of hospital stay. Follow-up will be scheduled on 6, 12, and 26 weeks after enrolment to assess AP recurrence, local complications, the requirement for surgical interventions, all-cause mortality, and patient-reported outcomes. Discussion: The results of this study will provide high-quality evidence to appraise the efficacy of CQCQD for the early management of AP patients. Trial registration: Chictr.org.cn Registry (ChiCTR2000034325). Registered on 2 July, 2020.

Protein glycosylation plays a pivotal role in human semen, influencing various processes, such as spermatogenesis, maturation, sperm motility, capacitation, and fertilization. Despite its importance, the specific details regarding N/O-glycosylation within human semen proteins have largely remained unknown. To address this challenge, an integrated glycoproteomic platform (termed GlycoIP) was developed, enabling the simultaneous analysis of both intact N- and O-glycopeptides directly from human semen samples. Characterizing these intact glycopeptides is particularly challenging, yet it provides invaluable insights into the structure and function of both glycans and their attachment sites. In this study, our platform enabled the identification of 1,833 unique N-glycopeptides and 720 unique O-glycopeptides. This approach revealed extensive and precise site-specific N/O-glycosylation data, highlighting 438 potential O-glycosylation sites from 148 distinct O-glycoproteins. Notably, we conducted site-specific N/O-glycosylation profiling on several unique glycoproteins, including sperm equatorial segment protein 1 (SPESP1), which is located on human sperm, and plasma serine protease inhibitor (SERPINA5), which is presented in both sperm and seminal plasma. In summary, this platform provides a promising approach for comprehensive profiling of protein site-specific N/O-glycosylation within a single experiment. This advancement paves the way for further functional studies on glycoproteins and their roles in male infertility, enhancing our understanding of this complex field.