Greater Los Angeles Clinical Center of the Consortium for the Study of Chronic Pancreatitis, Diabetes and Pancreatic Cancer

这是一份关于慢性病研究联盟临床中心名称更新的申请。 胰腺炎、糖尿病和胰腺癌（CPDPC）。大洛杉矶临床中心提供了 在CPDPC的组织和进展中发挥了相当大的领导作用。潘多尔博士担任联合主席， Goodarzi博士是3c型工作组的联合主席。我们在招聘方面表现出色 通过CPDPC实施的队列研究的参与者和保留，旨在阐明 慢性胰腺炎（CP）的自然史和诊断、治疗和临床管理方法的发展 及其在儿童和成人中的并发症，并确定糖尿病和 发展胰腺癌的早期诊断和治疗手段。此外，本发明还提供了一种方法， 我们一直在进行一些辅助和相关的研究，以支持CPDPC的总体目标， 包括：1.定义胰腺癌危险因素和CP自然史的流行病学研究; 2. 确定2型糖尿病的遗传易感性是与CP相关的糖尿病的一个强危险因素; 3.开发液体活检检测方法，用于辅助胰腺癌和CP的诊断; 4.调查 胰腺炎和胰腺癌的合理药物治疗机制;和5.进行 用于治疗复发性急性和慢性胰腺炎的试点临床试验。在CPDPC的下一阶段，我们 致力于实现以下具体目标： 1.继续招募和保留CPDPC队列研究（PROCEED、INSPPIRE 2、NOD， DETECT），以及增加研究人群的多样性。 2.继续目前支持的辅助研究，以进一步开发风险因素模型， 慢性胰腺炎和胰腺癌早期诊断的活检检测，以及先进的机制- 复发性急性和慢性胰腺炎以及胰腺癌的基础治疗和临床试验。 3.建立联合收割机的临床特征与遗传易感性相结合的模型，以预测未来 慢性胰腺炎患者的糖尿病发展。 4.确定胰腺酶替代治疗在调节糖尿病患者血糖稳态中的作用 慢性胰腺炎和糖尿病，伴或不伴胰腺外分泌不足。 5.使用现有的和带注释的诊断前CT扫描来开发基于人工智能的技术， 高灵敏度和特异性的方法，用于基于CT的早期胰腺癌检测。 我们的中心包括雪松西奈医疗中心，加州大学洛杉矶分校医疗中心，退伍军人管理局大洛杉矶 医疗保健系统和南加州大学/洛杉矶公共卫生系统， 组织结构旨在将招募扩大到具有更大多样性的CPDPC队列研究中 并促进我们参与辅助研究。

This is an application for renewal of Clinical Center designation of the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer (CPDPC). The Greater Los Angeles Clinical Center has provided considerable leadership in the organization and progress of the CPDPC. Dr. Pandol serves as co-chair of the Steering Committee and Dr. Goodarzi co-chairs the Type 3c Working Group. We have excelled in recruitment and retention of participants in the cohort studies implemented through the CPDPC designed to elucidate the natural history and develop means of diagnosis, treatment and clinical management of chronic pancreatitis (CP) and its complications in children and adults, and to determine the pathogenic interrelationships of diabetes and pancreatic cancer and develop the means of early diagnosis and management of pancreatic cancer. In addition, we have been performing a number ancillary and associated studies to support the overall goals of CPDPC, including: 1. Epidemiologic studies defining risk factors for pancreatic cancer and the natural history of CP; 2. Determining that genetic susceptibility for type 2 diabetes is a strong risk factor for diabetes associated with CP; 3. Developing liquid biopsy assays for aiding in the diagnosis of pancreatic cancer and CP; 4. Investigating mechanisms of pancreatitis and pancreatic cancer for rational pharmaceutical treatments; and 5. Conducting pilot clinical trials for treatment of recurrent acute and chronic pancreatitis. For the next phase of the CPDPC we are committed to the following Specific Aims: 1. Continue recruitment and retention of subjects in CPDPC cohort studies (PROCEED, INSPPIRE 2, NOD, DETECT) in existing and additional study sites, as well as increase diversity in the study population. 2. Continue currently supported ancillary studies to further develop risk factor models combined with liquid biopsy assays for early diagnosis of chronic pancreatitis and pancreatic cancer, and advance mechanism- based treatments and clinical trials for recurrent acute and chronic pancreatitis and pancreatic cancer. 3. Build models that combine clinical features with genetic susceptibility to allow the prediction of future development of diabetes in patients with chronic pancreatitis. 4. Determine the role of pancreatic enzyme replacement in regulating glucose homeostasis in patients with chronic pancreatitis and diabetes, with or without pancreatic exocrine insufficiency. 5. Use existing and annotated pre-diagnostic CT scans to develop artificial intelligence-based techniques for highly sensitive and specific methods for CT-based early pancreatic cancer detection. Our Center involves Cedars-Sinai Medical Center, UCLA Medical Center, the VA Greater Los Angeles Healthcare System and the University of Southern California/Los Angeles Public Health System with an organizational structure designed to expand recruitment into cohort studies of CPDPC with increased diversity and to facilitate our participation in ancillary studies.