RESUMO
Severe acute pancreatitis (SAP) accounts for up to 20% of acute pancreatitis (AP) cases. The absence of effective treatment options has resulted in a high rate of morbidity and mortality. Emodin is a major component of the Chinese herb rhubarb, which has been widely used in the treatment of numerous diseases, including inflammation and cancer. There are a limited number of studies however, that have investigated the effectiveness of emodin in the treatment of SAP. The present study used a rat model of SAP, to investigate the effect and molecular mechanisms of emodin treatment. Administration of emodin was identified to significantly attenuate SAP, as determined by serum amylase analysis and histological assessment of edema, vacuolization, inflammation and necrosis (P<0.01). Furthermore, treatment with emodin markedly inhibited nuclear factor (NF)κB DNAbinding activity (P<0.01) and the serum expression levels of tumor necrosis factorα, interleukin (IL)6 and IL1ß (P<0.05). This attenuation was associated with decreased malondialdehyde and increased superoxide dismutase levels in the pancreatic tissues and serum (P<0.05). This study indicated that administration of exogenous emodin had therapeutic effects on the severity of SAP. The mechanism may be due to inhibition of NFκB activation resulting in an antioxidation response, which can subsequently suppress the expression of cytokines.
Assuntos
Antioxidantes/farmacologia , Emodina/farmacologia , NF-kappa B/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Pancreatite/patologia , Doença Aguda , Amilases/sangue , Animais , Antioxidantes/uso terapêutico , Modelos Animais de Doenças , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Emodina/uso terapêutico , Interleucina-1beta/metabolismo , Interleucina-6/metabolismo , Estimativa de Kaplan-Meier , Masculino , Malondialdeído/análise , Malondialdeído/sangue , NF-kappa B/antagonistas & inibidores , Pancreatite/tratamento farmacológico , Pancreatite/mortalidade , Ratos , Ratos Sprague-Dawley , Rheum/química , Rheum/metabolismo , Índice de Gravidade de Doença , Superóxido Dismutase/análise , Superóxido Dismutase/sangue , Fator de Necrose Tumoral alfa/metabolismoRESUMO
A 62-year-old woman was admitted to our hospital in 2011 because of recurrent abdominal pain, nausea and constipation for six months. Computed tomography enterography (CTE) showed tortuous thread-like calcifications in the ileocolic vein and right colic vein, while colonoscopy revealed purple-blue mucosa extending from the cecum to the splenic flexure. Based on the results of these tests, the patient was diagnosed with idiopathic mesenteric phlebosclerosis (IMP). She had a history of Chinese medical liquor intake for one and a half years and her symptoms subsided after conservative treatment. In 2013, a 63-year-old male patient who presented with recurrent lower right abdominal pain, bloating, melena and diarrhea for fifteen months was admitted to our institution. Colonoscopy and CTE led to the diagnosis of IMP. He also used Chinese medical liquor for approximately 12 years. The patient underwent total colectomy and the postoperative course was uneventful. We searched for previously published reports on similar cases and analyzed the clinical data of 50 cases identified in PubMed. As some of these patients admitted use of Chinese medicines, we hypothesize that Chinese medicines may play a role in the pathogenesis of IMP.