The Role of Heparanase in the Pathogenesis of Acute Pancreatitis: A Potential Therapeutic Target.

Acute pancreatitis (AP) is one of the most common diseases in gastroenterology. However, neither the etiology nor the pathophysiology of the disease is fully understood and no specific or effective treatment has been developed. Heparanase is an endoglycosidase that cleaves heparan sulfate (HS) side chains of HS sulfate proteoglycans into shorter oligosaccharides, activity that is highly implicated in cellular invasion associated with cancer metastasis and inflammation. Given that AP involves a strong inflammatory aspect, we examined whether heparanase plays a role in AP. Here, we provide evidence that pancreatic heparanase expression and activity are significantly increased following cerulein treatment. Moreover, pancreas edema and inflammation, as well as the induction of cytokines and signaling molecules following cerulein treatment were attenuated markedly by heparanase inhibitors, implying that heparanase plays a significant role in AP. Notably, all the above features appear even more pronounced in transgenic mice over expressing heparanase, suggesting that these mice can be utilized as a sensitive model system to reveal the molecular mechanism by which heparanase functions in AP. Heparanase, therefore, emerges as a potential new target in AP, and heparanase inhibitors, now in phase I/II clinical trials in cancer patients, are hoped to prove beneficial also in AP.

Collaboration behind-the-scenes: key to effective interprofessional education.

A variety of stakeholders, including students, faculty, educational institutions and the broader health care and social service communities, work behind-the-scenes to support interprofessional education initiatives. While program designers are faced with multiple challenges associated with implementing and sustaining such programs, little has been written about how program designers practice the interprofessional competencies that are expected of students. This brief report describes the backstage collaboration underpinning the Dalhousie Health Mentors Program, a large and complex pre-licensure interprofessional experience connecting student teams with community volunteer mentors who have chronic conditions to learn about interprofessional collaboration and patient/client-centered care. Based on our experiences, we suggest that just as students are required to reflect on collaborative processes, interprofessional program designers should examine the ways in which they work together and take into consideration the impact this has on the delivery of the educational experience.

The Dalhousie Health Mentors Program: introducing students to collaborative patient/client-centered practice.

The Dalhousie Health Mentors Program builds on a long history of interprofessional health education initiatives by introducing students in health and social care professions to chronic conditions and disabilities, patient/client-centredness, interprofessional learning, and team functioning. This large interprofessional education program (16 participating programs, 650 students) connects interprofessional student teams with Health Mentors, who are adult volunteers with chronic conditions, for a learning experience that extends over one academic year. Students explore their mentor's life story and chronic condition journey, the impact the condition has had on her/his life, and her/his experience with health care in general and interprofessional collaboration in particular. All aspects of the program planning, management, implementation, and evaluation have been interprofessional in nature. Lessons have been learned regarding.