Inflammatory mediators and microcirculatory disturbance in acute pancreatitis

BACKGROUND:Inflammatory mediators are not only initiation factors of acute pancreatitis(AP)but also key factors causing pancreatic hemorrhage and necrosis,which damage important organs such as the heart,brain,liver, kidney and lung.Microcirculatory disturbance in AP has attracted widespread attention.In order to provide a theoretical basis for clinical therapy of AP,it is very important to explore the effect of inflammatory mediators on microcirculatory disturbance in this disease. DATA SOURCES:In this review,the impact of inflammatory mediators on microcirculatory disturbance in AP was reviewed according to the literature,especially the articles indexed in PubMed and books published in China and reports from websites. RESULTS:At present,inflammatory mediation and micro- circulatory disturbance are the two major hypotheses to explain the development of AP.Although experimental studies have shown that inflammatory mediators induce or aggravate microcirculatory disturbance,the clinical application of these findings is still difficult because the inflammatory mediators are diverse and their research is not comprehensive and thorough. CONCLUSION:It is very important to explore the influence of inflammatory mediators on microcirculatory disturbance in AP.

Pathological changes at early stage of multiple organ injury in a rat model of severe acute pancreatitis

BACKGROUND:Severe acute pancreatitis (SAP) is a commonly seen acute abdominal syndrome characterized by sudden onset,rapid progression and high mortality rate.The damage in peripheral organs may be more severe than that in the pancreas,and can even lead to multiple organ dysfunction.It is critical to recognize early pathological changes in multiple organs.This study aimed to assess the early pathological features of damaged organs in a rat model of SAP.METHODS:Thirty clean grade healthy male Sprague-Dawley rats weighing 250-300 g were randomly divided into a model control group (n=15) and a sham-operated group (n=15).The SAP rat model was induced by sodium taurocholate.Samples of blood and from multiple organs were collected 3 hours after operation.We assessed the levels of IL-6,TNF-α,PLA2,NO,ET-1,MDA,amylases and endotoxin in blood and observed the early pathological changes in multiple damaged organs.RESULTS:Levels of IL-6,TNF-α,PLA2,NO,ET-1 and MDA in serum and of amylase and endotoxin in plasma of the model control group rats were significantly higher than those of the sham-operated group (P<0.01).Different degrees of pathological change were observed in multiple damaged organs.CONCLUSION:Multiple organ injury may occur at the early stage of SAP in rats.

Donor denervation and elimination of Kupffer cells affect expression of P-selectin and ICAM-1 in liver graft

BACKGROUND:The non-function and dysfunction of primary liver graft likely involves dependence on Kupffer cells and hepatic innervation. The present experiment was designed to study the expression of P-selectin and intercellular adhesion molecule-1(ICAM-1) mRNA in liver graft and to elucidate the role of Kupffer cells and the sympathetic nerve of the liver in down-regulating this expression. METHODS:Donor rats were given hexamethonium,a sympathetic ganglionic blocking agent,and/or gadolinium chloride,an inhibitor of Kupffer cells. Then the changes of graft P-selectin and ICAM-1 mRNA expression were measured after liver transplantation. RESULTS:The expressions of P-selectin and ICAM-1 mRNA were increased after liver transplantation,and down-regulated by liver denervation and elimination of Kupffer cells. CONCLUSIONS:Live donor denervation and elimination of Kupffer cells down-regulated the expressions of P-selectin and ICAM-1 mRNA in grafts. This may decrease graft ischemia/reperfusion injury.

Pathological changes in multiple organs of rats with severe acute pancreatitis treated by baicalin and octreotide

BACKGROUND:Severe acute pancreatitis(SAP)features fatal pathogenetic conditions and high mortality rate.The study of SAP complicated with multiple organ injuries is of important significance.In this study,we explored the protective effect of baicalin on multiple organs of SAP rats and compared it with that of octreotide through light and electron microscopic observations of the pathological changes. METHODS:The improved Aho method was used to prepare SAP rat models.These rats were then randomly divided into a sham-operated group(n=45),a model control group(n=45), baicalin-treated group(n=45)and octreotide-treated group (n=45).Based on the difference in time points after operation, these groups were subdivided into 3,6 and 12 hour subgroups (n=15).At the corresponding time point after operation,the mortality rate of rats was recorded,and then the rats were humanely killed to take samples of multiple organs that were subsequently examined for pathological changes under light and electron microscopy. RESULTS:At 12 hours after operation,the mortality rate of rats in the baicalin-and octreotide-treated groups was lower than that in the model control group(P【0.05).Compared to the model control group,the pathological changes and pathological scores in the baicalin-and octreotide-treated groups were mitigated and relieved to varying degrees.The pathological changes under electron microscopy were also improved.CONCLUSIONS:Both baicalin and octreotide show good protective effects on multiple organs of SAP rats.Baicalin as a new drug has good prospects in the treatment of SAP.