Histochemical studies on enzyme-digested protein plugs of patients with chronic pancreatitis: a preliminary report.

Sulfated acidic mucopolysaccharides have been found to be significant components of "protein plugs" in patients with chronic pancreatitis. The precise identification of the mucopolysaccharides and their distribution within the protein plugs may clarify the pathogenesis of the plugs. Pure pancreatic juice from five patients with chronic pancreatitis was obtained by endoscopic retrograde catheterization of the papilla of Vater. Enzymes for digestion of the plugs included hyaluronidase of the bovine testes and streptomyces hyalurolyticus, chondroitinase ABC and AC, and sialidase (neuraminidase). Our study indicated that: I) Sialic acid is distributed throughout the plugs and may be a major component, followed by a lesser amount of chondroitin sulfate B. 2) Chondroitin sulfate A, C, D and E and chondroitin may be minor components. 3) Hyaluronic acid is negligible in the plugs.