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1.
Zentralbl Chir ; 138(4): 471-9, 2013 Aug.
Article in German | MEDLINE | ID: mdl-23575520

ABSTRACT

BACKGROUND: Due to uncontrolled activation of digestive enzymes produced within the pancreas, acute pancreatitis is a disease with a great potential for complications and variable course. Since the pathophysiological steps of human pancreatitis can only be inadequately investigated, various animal models were established to study the course of disease. The model of supramaximal caerulein stimulation allows to gain insights into intracellular events of the early phase of acute pancreatitis. Usually, overnight fasted animals are used for the model of acute pancreatitis to achieve a maximum zymogen granula accumulation and a standardised initial situation due to diminished secretion of CCK. Furthermore, the role of the nutritional state for pathogenesis and course of acute pancreatitis is controversially discussed. The aim of the study was to investigate the impact of the nutritional status on pancreatic injury in experimental acute pancreatitis. METHODS: Using standardised supramaximal caerulein stimulation (dose: 50 µg/kg; time intervals, 1/h; max. 7×), acute oedematous interstitial pancreatitis in fasted and non-fasted mice was induced. Pancreatic injury was locally characterised by pancreatic oedema, histopathological alterations and the release of pancreatic enzyme to the serum while systemic alterations were objectified by IL-6, CRP und pulmonal MPO. RESULTS: 1) Increased pancreatic serum enzyme levels after induction of acute pancreatitis in non-fasted animals do not reflect a greater affection of the pancreas since amylase and lipase in serum and pancreatic tissue correlate proportionally. The induction of acute pancreatitis provoked release of 1.3 % and 0.7 % of amylase and lipase, respectively, independently of nutritional status. 2) Neither local nor systemic parameters of pancreatic injury were significantly altered by the nutritional regimen. Pathohistologic investigations revealed increase of zymogen granula portion and cell size in non-fasted mice but no further differences compared with fasted animals. 3) During a 16-hour recovery period (no further caerulein injection), local and systemic parameters normalised. DISCUSSION: In the relatively mild model of pancreatitis induced by hormonal hyperstimulation, there was no greater pancreatic injury despite higher intrapancreatic enzyme accumulation in non-fasted animals indicating a steady state between potentially damaging and protective factors and mechanisms.


Subject(s)
Disease Models, Animal , Nutritional Status , Pancreatitis, Acute Necrotizing/physiopathology , Animals , Cholecystokinin/physiology , Enzyme Precursors/physiology , Female , Humans , Male , Mice , Mice, Inbred Strains , Pancreas/pathology , Pancreas/physiopathology , Pancreatic Juice/physiology , Pancreatitis, Acute Necrotizing/complications , Pancreatitis, Acute Necrotizing/pathology , Secretory Vesicles/pathology , Secretory Vesicles/physiology
2.
Unfallchirurg ; 116(7): 596-601, 2013 Jul.
Article in German | MEDLINE | ID: mdl-22367521

ABSTRACT

BACKGROUND: Osteopenia (OP) or osteoporosis (OST) was diagnosed by bone densitometry (DXA) in postmenopausal women free of known skeletal disorders and without acute fracture. DVO guidelines were applied to define therapeutic indication. METHODS: The study included 94 women aged 59-81 years. Fracture or operation ≤12 months, malignant tumor, ovariectomy, and drugs such as cortisone, strontium, fluorides, bisphosphonates, SERMs, estrogens, and steroids were exclusion criteria. The lowest T-score at the spine, femoral neck, or total hip was decisive. The indication for therapy was determined by evaluating age, BMD, and other risk factors. RESULTS: Using the WHO criteria 22.3% (n=21) had normal BMD, 52.1% (n=49) had OP, and 25.6% (n=24) had OST. According to "Dachverband Osteologie" (DVO) guidelines, 28 women (29.8%) of the whole group needed therapy. Of the 28 women receiving therapy, 9 had OP and 19 had OST. Therapy was indicated in 18.4% for OP and 79.2% for OST. CONCLUSION: A preventive measurement of BMD with DXA provides a benefit for postmenopausal women. Combinatory assessment and consideration of other risk factors allows identification of women who might benefit from early treatment.


Subject(s)
Absorptiometry, Photon/standards , Bone Density Conservation Agents/therapeutic use , Mass Screening/standards , Osteology/standards , Osteoporosis, Postmenopausal/diagnosis , Osteoporosis, Postmenopausal/prevention & control , Practice Guidelines as Topic , Absorptiometry, Photon/statistics & numerical data , Aged , Aged, 80 and over , Bone Density , Comorbidity , Female , Germany/epidemiology , Humans , Male , Mass Screening/statistics & numerical data , Middle Aged , Osteoporosis, Postmenopausal/epidemiology , Osteoporotic Fractures/epidemiology , Osteoporotic Fractures/prevention & control , Prevalence , Reproducibility of Results , Risk Factors , Sensitivity and Specificity
3.
Surg Endosc ; 25(2): 577-85, 2011 Feb.
Article in English | MEDLINE | ID: mdl-20614136

ABSTRACT

BACKGROUND: Experimental data about the efficacy and safety of sealing devices are rare. Therefore, this study investigated these parameters for three commercially available energy-based vascular sealing and cutting systems. METHODS: In male hybrid pigs, 487 carotid artery segments were sealed and cut using the harmonic scalpel or several bipolar sealing devices. The sealing failure rate, burst pressure, process time, and extent of lateral thermal damage were analyzed. RESULTS: A regular sealing and cutting process in more than 90% of the carotid arteries was found using the following instruments: LS1520, ACE (level 1), ACE (level 3), CS14C (level 1), WAVE (level 1), and WAVE (level 5). The largest failure rate was found for the CS14C device (level 5: initial sealing failure, 21.5%). The maximal mean burst pressure (1727±453 mmHg) was reached using the ACE device (level 1). Significant differences were found in the size of the lateral thermal damage, which a ranged from 2.5 mm (LS1520) to 1.51 mm (CS14C, level 1). The process time ranged widely from 6.8 s (ACE, level 5) to 31.83 s (WAVE, level 1). CONCLUSION: The current study demonstrated that all the tested devices are efficacious and safe in sealing and cutting arteries up to 5 mm in diameter. All the devices showed supraphysiologic mean burst pressures. Differences in failure rate, thermal damage, and process time lead to an advised application of the different systems.


Subject(s)
Carotid Arteries/surgery , Electrocoagulation/instrumentation , Hemostasis, Endoscopic/instrumentation , Ultrasonic Therapy/instrumentation , Vascular Surgical Procedures/instrumentation , Analysis of Variance , Animals , Disease Models, Animal , Electrocoagulation/methods , Equipment Design , Equipment Safety , Hemostasis, Endoscopic/methods , Male , Random Allocation , Swine , Tensile Strength , Vascular Surgical Procedures/methods
4.
Langenbecks Arch Surg ; 394(2): 363-9, 2009 Mar.
Article in English | MEDLINE | ID: mdl-18690472

ABSTRACT

BACKGROUND: Early events in the pathogenesis of experimental acute pancreatitis are intensively studied using isolated cells or animal models. However, the results and their interpretations are dependent on the complexity of biological structures. Therefore, we proposed that studies on isolated perfused pancreas can give additional information about processes leading to acinar cell injury. This hypothesis was examined adapting the well-established caerulein hyperstimulation model and the taurocholate model of acute pancreatitis to the extracorporeal perfused isolated rat pancreas. MATERIALS AND METHODS: The pancreas was removed with the duodenum including the arterial supply. A continuous perfusion of the organ was performed with a modified Krebs-Ringer bicarbonate buffer. Intraarterial caerulein application or an intraductal taurocholate (3.5%) application were used to induce acinar cell injury which was determined as the release of amylase, lipase and lactate dehydrogenase into the portal outflow medium and into the transudation fluid and by examination of histological alterations. Trypsinogen release and activation was followed by analysis of trypsinogen activation peptide (TAP) in the transudation fluid and in pancreatic tissue. RESULTS: Perfusion of isolated rat pancreas with supramaximal concentrations of caerulein or retrograde injection of taurocholate (3.5%) resulted in acinar cell injury indicated by elevated levels of amylase and lipase into the perfusate and into the transudation fluid. TAP levels in the transudation fluid significantly increased after perfusion with caerulein or retrograde injection of taurocholate (3.5%). The histological alterations after taurocholate application include oedema and necrosis and show significant differences to the control perfusion. Extensive pancreatic necroses were not observed after caerulein hyperstimulation. CONCLUSIONS: The isolated perfused rat pancreas is a useful model to investigate pathophysiological mechanisms which are relevant for the early phase of acute pancreatitis. The caerulein and the taurocholate models are transferable to the isolated rat pancreas. Studies on isolated perfused rat pancreas enable pathophysiological investigations of the exocrine pancreas without influence of systemic components, but with preserved morphology.


Subject(s)
Ceruletide/pharmacology , Cholagogues and Choleretics/pharmacology , Disease Models, Animal , Gastrointestinal Agents/pharmacology , Pancreatitis, Acute Necrotizing/chemically induced , Taurocholic Acid/pharmacology , Amylases/metabolism , Animals , Dose-Response Relationship, Drug , Humans , In Vitro Techniques , Lipase/metabolism , Male , Pancreas/drug effects , Pancreas/pathology , Pancreatitis, Acute Necrotizing/pathology , Perfusion , Rats , Rats, Wistar
7.
Anticancer Drugs ; 13(6): 605-14, 2002 Jul.
Article in English | MEDLINE | ID: mdl-12172506

ABSTRACT

Following surgical resection of colorectal carcinoma, local recurrence in the tumor bed or in the mesentery remains a frequently encountered problem. Currently there are no recognized standard therapy protocols for the prevention of local recurrence or the treatment of peritoneal carcinomatosis. The aim of our trial was to investigate whether CPT-11 and oxaliplatin could decrease i.p. tumor growth in a basic experimental animal model. Experiments were performed on three groups of animals plus controls. In the first group, the cytostatic agents were applied directly following tumor cell implantation into the peritoneal cavity. In the second group, early postoperative i.p. chemotherapy (days 5, 10 and 15 following surgery) was administered. In the third group, late i.p. chemotherapy (days 15, 20 and 25 after tumor cell transfer) was administered with the intention of reducing a manifest peritoneal carcinomatosis. The trial also set out to describe any side effects observed following i.p. administration. The results indicated that CPT-11 and oxaliplatin were highly effective in reducing i.p. tumor spread after direct i.p intraoperative application. Intraperitoneal administration of CPT-11 or oxaliplatin also decreased i.p. tumor growth after early i.p. chemotherapy. CPT-11 was a little more effective with lower side effects. However, it was clear that it was not possible to treat a manifest peritoneal carcinomatosis in this way.


Subject(s)
Antineoplastic Agents, Phytogenic/therapeutic use , Antineoplastic Agents/therapeutic use , Camptothecin/analogs & derivatives , Camptothecin/therapeutic use , Carcinoma/prevention & control , Organoplatinum Compounds/therapeutic use , Peritoneal Neoplasms/prevention & control , Anesthesia , Animals , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/adverse effects , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Agents, Phytogenic/adverse effects , Camptothecin/administration & dosage , Camptothecin/adverse effects , Carcinoma/pathology , Injections, Intraperitoneal , Irinotecan , Male , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/prevention & control , Neoplasm Transplantation , Organoplatinum Compounds/administration & dosage , Organoplatinum Compounds/adverse effects , Oxaliplatin , Peritoneal Neoplasms/pathology , Rats , Tumor Cells, Cultured
8.
Langenbecks Arch Surg ; 387(3-4): 170-6, 2002 Jul.
Article in English | MEDLINE | ID: mdl-12172863

ABSTRACT

BACKGROUND: Oxidative stress is a relevant event in the pathogenesis of acute pancreatitis. Investigations in vivo are limited because of the complexity of the organism and the short half-life of free radicals. The isolated perfused rat pancreas could be useful for investigations in the early phase of acute pancreatitis especially under conditions of oxidative stress. METHODS: External perfusions of the pancreatic glands of Wistar rats were carried out using a modified Krebs-Ringer buffer including an additive of the detergents Triton X-100 and a perfusion including hydrogen peroxide (0.0012%) or tert-butylhydroperoxide (0.0042%) or xanthine oxidase (0.1 U/ml). Changes in amylase, lipase, LDH in the portal outflow fluid and for histological alterations were analyzed. RESULTS: Damage to pancreatic parenchyma using Triton X-100 was indicated by increased levels of pancreatic enzymes in the perfusion medium. During perfusion with hydrogen peroxide or tert-butylhydroperoxide we found no changes in pancreatic enzymes in the portal outflow. In contrast, perfusion with xanthine oxidase induced a significant elevation in lipase and amylase in the effusion fluid after 30 min. We found a significant increase in edema in the hydrogen peroxide and in the xanthine oxidase group. Focal necroses of the pancreatic parenchyma were detected in all groups of oxidative stress. CONCLUSIONS: The isolated perfused rat pancreas is a valuable experimental model for investigating the early phase of pathophysiology in acute pancreatitis, for instance, the effect of oxidative stress as an early event in acute pancreatitis. Using hydrogen peroxide tert-butylhydroperoxide or xanthine oxidase, only xanthine oxidase was able to induce a typical elevation in the pancreas enzymes in the effusion fluid.


Subject(s)
Disease Models, Animal , Oxidative Stress , Pancreatitis/enzymology , Pancreatitis/pathology , Acute Disease , Amylases/analysis , Animals , Biopsy , Detergents , Hydrogen Peroxide , In Vitro Techniques , L-Lactate Dehydrogenase/analysis , Lipase/analysis , Lipid Peroxidation , Male , Malondialdehyde/analysis , Necrosis , Octoxynol , Organ Size , Pancreatitis/etiology , Pancreatitis/physiopathology , Perfusion/methods , Rats , Rats, Wistar , Xanthine Oxidase , tert-Butylhydroperoxide
9.
Zentralbl Chir ; 126(11): 929-33, 2001 Nov.
Article in German | MEDLINE | ID: mdl-11753807

ABSTRACT

METHODS: External perfusions of the pancreatic glands of Wistar-rats were done, using a modified Krebs-Ringer-Buffer (KRB). We looked for an elevation of amylase, lipase and lactate-dehydrogenase in the effusion fluid (portal outflow fluid). We investigated a normal perfusion (KRB, 60 minutes), a long term perfusion (KRB, 240 minutes) and a perfusion (60 minutes) including an additive of the detergents triton x-100 or the cholecystokinin analogue ceruletid (10(-8) M). RESULTS: An isolated external perfusion of a rat pancreas is possible without inducing any increase of parameters of damage such as amylase, lipase or lactate-dehydrogenase in the outflow medium. The perfusion time should be limited to 80 minutes including a 20 minutes equilibration period. A damage of pancreatic parenchyma is indicated by increased levels of pancreatic enzymes in the perfusion medium. Such damage can be induced by various noxious substances like detergents or cerulein, which has a significance in the pathophysiology of experimental acute pancreatitis. A significant increase (p < 0.01) of lactate-dehydrogenase, lipase and amylase was found 10, 20 and 30 minutes after an application of triton x-100. During a perfusion with the cholecystokinin analogue ceruletid (10(-8) M) we found an increase of lipase (p < 0.05) after 30 minutes and an increase of amylase (p < 0.05) after 50 minutes perfusion. CONCLUSIONS: The isolated perfused rat pancreas is a valuable experimental model to investigate the early phase of pathophysiology in acute pancreatitis.


Subject(s)
Pancreas , Pancreatitis/etiology , Acute Disease , Amylases/analysis , Analysis of Variance , Animals , Ceruletide/pharmacology , Detergents/pharmacology , Gastrointestinal Agents/pharmacology , In Vitro Techniques , L-Lactate Dehydrogenase , Lipase/analysis , Male , Models, Animal , Pancreas/drug effects , Pancreas/enzymology , Pancreatitis/physiopathology , Perfusion , Polyethylene Glycols/pharmacology , Rats , Rats, Wistar , Time Factors
10.
Zentralbl Chir ; 126(11): 934-8, 2001 Nov.
Article in German | MEDLINE | ID: mdl-11753808

ABSTRACT

METHODS: The pancreas of 24 male Wistar rats was perfused extracoporally by modified Krebs-Ringer-buffer for 80 minutes (including a 20 minutes equilibration period). To verify any organ damage we measured the activity of pancreatic enzymes like amylase, lipase and lactatdehydrogenase in the portal effluent. Furthermore histological changes were analysed after perfusion. Organ damage was induced by adding cerulein in a physiological dose (10(-10) M, n = 6) and in a supramaximal dose (10(-8) M, n = 6) and by intraductal injection of taurocholate (3.5 %, n = 6). RESULTS: Already 10 minutes after stimulation with cerulein (10(-8) M) and after intraductal injection of taurocholate increased activities (p < 0.01) of amylase and lipase were measured in the portal effluent compared to the group without any treatment. Lactatdehydrogenase levels did not changed. Apart from marked oedema in both groups considerable zones of necrosis could be noticed especially in the taurocholate group. CONCLUSION: Our data suggest that the isolated perfused rat pancreas (IPRP) is a valuable experimental tool to verify pathophysiological changes in the early phase of acute pancreatitis (AP). Various established models of AP such as by cerulein hyperstimulation or intraductal injection of taurocholate, could be applied to the IPRP. We conclude that this method enlarges the spectrum of established experimental models of acute pancreatitis.


Subject(s)
Pancreas , Pancreatitis/etiology , Acute Disease , Amylases/analysis , Animals , Ceruletide/pharmacology , Cholagogues and Choleretics/pharmacology , Detergents/pharmacology , Disease Models, Animal , Gastrointestinal Agents/pharmacology , In Vitro Techniques , L-Lactate Dehydrogenase/analysis , Lipase/analysis , Male , Necrosis , Pancreas/drug effects , Pancreas/enzymology , Pancreas/pathology , Pancreatitis/physiopathology , Perfusion , Rats , Rats, Wistar , Taurocholic Acid/pharmacology , Time Factors
11.
Int J Colorectal Dis ; 16(5): 340-5, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11686534

ABSTRACT

BACKGROUND AND AIMS: We compared the effectiveness and side effects of various cytostatic agents for use in perioperative intraperitoneal irrigation to prevent peritoneal carcinomatosis. METHODS: The adenocarcinoma cell line CC-531 was implanted during laparotomy at the mesenterial trunk of anesthetized male WAG rats. Direct perioperative intraperitoneal chemotherapy was performed after 5 min with either 5-fluorouracil, cisplatin, or mitomycin; controls received only tumor cells. The animals were inspected daily over 30 days for side effects. They were then killed, and the greater omentum and mesentery were resected, the tumor mass was examined for the presence of peritoneal carcinomatosis, and tumor nodules in the greater omentum and mesentery were counted. RESULTS: All the animals in the control group developed histologically confirmed peritoneal carcinomatosis. Animals receiving cisplatin or mitomycin by direct intraperitoneal perioperative chemotherapy showed no macroscopic or histological evidence of tumor growth. Two animals in the fluorouracil group had macroscopically and histologically manifest tumor growth; another animal showed only histological evidence of malignancy. Substantial side effects were noted in the cisplatin group, with all animals experiencing bleeding in the peritoneum and toxic necrotic reactions of the colon; two animals died of these side effects. CONCLUSION: Direct intraperitoneal chemotherapy with cisplatin or mitomycin prevents peritoneal carcinomatosis in experimental investigations.


Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents/administration & dosage , Cisplatin/administration & dosage , Fluorouracil/administration & dosage , Mitomycin/administration & dosage , Peritoneal Neoplasms/drug therapy , Adenocarcinoma/prevention & control , Animals , Antineoplastic Agents/therapeutic use , Cisplatin/therapeutic use , Fluorouracil/therapeutic use , Infusions, Parenteral , Male , Mitomycin/therapeutic use , Models, Animal , Peritoneal Neoplasms/prevention & control , Rats , Treatment Outcome
12.
Surg Endosc ; 15(8): 882-5, 2001 Aug.
Article in English | MEDLINE | ID: mdl-11443463

ABSTRACT

BACKGROUND: The balance between proteolysis and protease inhibition in the formation and breakdown processes of the extracellular matrix plays a major role in tumor cell invasion. An understanding of this relationship gave rise to the therapeutic concept of lowering tumor cell invasion by inhibiting protease activity. Phosphoramidon is an unspecific proteinase inhibitor. This experimental study investigated the effect of intraperitoneal phosphoramidon administration on tumor growth in a laparoscopic rat model. METHODS: In the first phase of the study, we investigated the influence of phosphoramidon on tumor cell invasion in a collagen matrix gel chamber in vitro. In a second experiment, a suspension of colon carcinoma cells (CC531) was introduced into the peritoneal cavity of male WAG rats. Prior to laparoscopy (at 6 mmHg for 20 min), the animals were randomized to two groups. At the start of laparoscopy, the test substance was applied intraperitoneally (group 1: controls, 1 ml 0.9% NaCl; group 2: 250 mg phosphoramidon in 1 ml 0.9% NaCl). Three weeks after the injection of tumor cells, the animals were autopsied and the tumor mass determined. RESULTS: In comparison with the control group (tumor weight 7.42 +/- 1.01 g), intraperitoneal tumor growth in the experimental group was significantly (p < 0.001) reduced by the application of phosphoramidon (tumor weight, 3.22 +/- 1.06 g). Phosphoramidon also significantly (p < 0.05) reduced tumor cell invasion through the matrix gel. CONCLUSION: The proteinase inhibitor phosphoramidon reduced tumor cell invasion in vitro and tumor cell growth in vivo in this laparoscopic rat model.


Subject(s)
Colonic Neoplasms/pathology , Glycopeptides/pharmacology , Neoplasm Seeding , Protease Inhibitors/pharmacology , Animals , Colonic Neoplasms/surgery , Injections, Intraperitoneal , Laparoscopy/adverse effects , Male , Neoplasm Invasiveness/prevention & control , Rats , Tumor Cells, Cultured/transplantation
13.
Surgery ; 129(6): 745-8, 2001 Jun.
Article in English | MEDLINE | ID: mdl-11391374

ABSTRACT

BACKGROUND: In most preclinical models, assessment of intraperitoneal tumor location and size require killing the animal. The dynamics of postoperative intraperitoneal tumor implantation and growth remain unclear. A noninvasive method allowing reliable in vivo, real-time assessment of tumor growth is desirable. METHODS: An intraperitoneal tumor homograft using cultured CC531 colorectal cells was created by laparotomy in 24 Wistar Albino Glaxo rats. Eight additional rats were used as controls. Then, 10 MBq technetium 99m-labeled anticarcinoembryonic antigen (anti-CEA) monoclonal antibodies were administrated intravenously and radioactivity uptake was measured by using extracorporeal gamma counting at various time points. Subsequently, the animals were killed for tumor weighting. In 2 more groups of 8 animals, real-time, repeated measures were performed. RESULTS: Correlation between gamma counting and tumor weight was highly significant (P <.001). The regression equation obtained by using the least squares method was: tumor weight (g) = 2.422 + 0.267 x counts. It was possible to obtain real-time tumor growth curves when repeated measurements of radioactivity were performed. At day 25, the predicted tumor weight was 8.49 +/- 0.76 g, the measured weight was 8.16 +/- 0.99 g. CONCLUSIONS: Immunoscintigraphic measurements with technetium 99m anti-CEA antibodies are highly correlated with tumor weight in this model. As opposed to other tumor graft models based on autopsy findings, real-time monitoring is possible. This will allow dynamic studies of intraperitoneal tumor implantation and growth and will reduce the number of animals used in further studies.


Subject(s)
Carcinoembryonic Antigen/immunology , Peritoneal Neoplasms/diagnostic imaging , Radioimmunodetection , Animals , Disease Models, Animal , Male , Peritoneal Neoplasms/pathology , Rats , Tumor Cells, Cultured
15.
Dig Dis Sci ; 46(4): 932-7, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11330437

ABSTRACT

Oxidative stress is considered to be a pathogenic factor for multisystem organ failure during acute pancreatitis. Infusion of 3% and 5% sodium taurocholate into the pancreatic duct of rats resulted in a 24-hr lethality of 8% and 82%, respectively. Kidney tissue showed a long-lasting significant elevation of malondialdehyde (lipid peroxidation). Only small amounts of this aldehyde were formed in the liver. In the lung malondialdehyde was increased during the first 6 hr after pancreatitis induction. Malondialdehyde levels were not different for pancreatitis initiated by 3% or 5% taurocholate. Protein-bound carbonyls (protein oxidation) in the tissues were not significantly changed at any time point. However, after infusion of 5% taurocholate, lung proteins were oxidatively modified by the product of lipid peroxidation, 4-hydroxynonenal. Another parameter characteristic for pancreatitis with high lethality was the high number of neutrophils in the lungs. We conclude that oxidative stress is important for the injury of extrapancreatic tissues during pancreatitis, but survival is determined by the degree of systemic inflammation.


Subject(s)
Pancreatitis/metabolism , Aldehydes/pharmacology , Animals , Lipid Peroxidation , Male , Malondialdehyde/metabolism , Oxidative Stress , Proteins/metabolism , Rats , Rats, Wistar , Severity of Illness Index
16.
Crit Care Med ; 29(4): 861-9, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11373483

ABSTRACT

OBJECTIVES: To evaluate the therapeutic potential of lazaroids in severe necrotizing acute pancreatitis and to investigate the association between oxidative stress, protease activation, and local production of proinflammatory cytokines and the severity and lethality of the disease. BACKGROUND: Oxidative stress is a crucial factor in the pathophysiology of acute pancreatitis and its systemic complications. Treatment with antioxidants, however, failed to improve survival in most studies performed so far. Lazaroids are a novel class of antioxidants that potently protect pancreatic acinar cells against oxidant attack in vitro. DESIGN: Prospective, randomized, controlled experimental study. SETTING: University research laboratory. SUBJECTS: Seventy-five anesthetized male Wistar rats (300-350 g). INTERVENTIONS: Severe acute pancreatitis was induced by retrograde injection of 3.5% taurocholate-sodium into the common bile-pancreatic duct. Interventions were performed to mimic the clinical situation, including continuous intravenous fluid substitution and administration of lazaroids in a therapeutic protocol. Therapy was started 1 hr after injection of the bile salt by using three different lazaroids, lactated Ringer's solution (placebo), and methylprednisolone as a corticosteroid control (n = 15 in each group). All the substances were given by continuous intravenous infusion throughout the 20-hr trial period. MEASUREMENTS AND MAIN RESULTS: Pancreatic homogenates and ascites were analyzed for indicators of oxidative stress, antioxidants, proteases, and proinflammatory cytokines. Pancreatic edema, morphologic pancreatitis severity, and pancreatic histopathology also were assessed. All three lazaroids and methylprednisolone diminished pancreatic tumor necrosis factor-alpha concentrations. Lethality was 33% in the placebo group. Neither the lazaroids nor methylprednisolone influenced survival. The local pancreatic and peritoneal concentrations of lipid peroxidation products, antioxidants, and proteases did not differ among the five groups. Nonsurviving rats, however, had a higher total protease activity in the pancreas and higher concentrations of trypsinogen activation peptide in ascites, as compared with surviving animals. There were no differences between survivors and nonsurvivors with regard to variables of oxidative stress and cytokines. CONCLUSIONS: Lazaroid application under clinically relevant conditions (i.e., after induction of fulminant acute pancreatitis) does not influence lethality or biochemical variables relevant to this disease. Protease activation rather than oxidative stress or local pancreatic cytokine production is an important determinant of disease severity and survival in acute pancreatitis. In experimental studies evaluating novel therapeutics, the same strict criteria should be applied as in the human setting.


Subject(s)
Antioxidants/therapeutic use , Pancreatitis, Acute Necrotizing/drug therapy , Animals , Male , Oxidative Stress , Pancreatitis, Acute Necrotizing/classification , Pancreatitis, Acute Necrotizing/enzymology , Pancreatitis, Acute Necrotizing/metabolism , Rats , Rats, Wistar , Trypsin/metabolism
17.
J Clin Invest ; 106(6): 773-81, 2000 Sep.
Article in English | MEDLINE | ID: mdl-10995788

ABSTRACT

Autodigestion of the pancreas by its own prematurely activated digestive proteases is thought to be an important event in the onset of acute pancreatitis. The mechanism responsible for the intrapancreatic activation of digestive zymogens is unknown, but a recent hypothesis predicts that a redistribution of lysosomal cathepsin B (CTSB) into a zymogen-containing subcellular compartment triggers this event. To test this hypothesis, we used CTSB-deficient mice in which the ctsb gene had been deleted by targeted disruption. After induction of experimental secretagogue-induced pancreatitis, the trypsin activity in the pancreas of ctsb(-/-) animals was more than 80% lower than in ctsb(+/+) animals. Pancreatic damage as indicated by serum activities of amylase and lipase, or by the extent of acinar tissue necrosis, was 50% lower in ctsb(-/-) animals. These experiments provide the first conclusive evidence to our knowledge that cathepsin B plays a role in intrapancreatic trypsinogen activation and the onset of acute pancreatitis.


Subject(s)
Cathepsin B/metabolism , Pancreas/enzymology , Pancreas/pathology , Pancreatitis/enzymology , Trypsinogen/metabolism , Acute Disease , Amylases/blood , Animals , Apoptosis/drug effects , Cathepsin B/deficiency , Cathepsin B/genetics , Ceruletide/pharmacology , Disease Models, Animal , Edema/pathology , Enzyme Activation , Gene Deletion , Gene Targeting , Humans , Lipase/blood , Mice , Mice, Knockout , Necrosis , Pancreas/drug effects , Pancreatitis/chemically induced , Pancreatitis/etiology , Phenotype
18.
Adv Exp Med Biol ; 477: 403-11, 2000.
Article in English | MEDLINE | ID: mdl-10849766

ABSTRACT

Autodigestion by proteolytic enzymes is thought to represent the critical mechanism by which acute pancreatitis is initiated. Where and why pancreatic proteases, which are physiologically stored and secreted as inactive precursor zymogens, are activated within the pancreas has remained controversial. Here we present data which indicate that: the lysosomal protease cathepsin B can activate trypsinogen in vitro in a manner that is similar to trypsinogen activation by enterokinase; that cathepsin B colocalizes with trypsinogen in the secretory compartment of the rat pancreas and of the human pancreas; that trypsinogen activation begins in a secretory compartment that is distinct from mature zymogen granules; and that the inhibition of cathepsin B can either increase or decrease premature trypsinogen activation depending on the concentration of the inhibitor, its specificity and its site of action in the pancreatic acinar cell. These observations elucidate some of the complex relations between cysteine and serine proteases in the pancreas with respect to their mechanisms of activation, their subcellular sites of action, and their possible role in the onset of pancreatitis.


Subject(s)
Cathepsin B/physiology , Pancreas/enzymology , Pancreatitis/enzymology , Trypsin/biosynthesis , Trypsinogen/metabolism , Acute Disease , Animals , Ceruletide/pharmacology , Ceruletide/toxicity , Cytoplasmic Granules/enzymology , Dogs , Enteropeptidase/physiology , Enzyme Activation , Humans , Lysosomes/enzymology , Mice , Pancreas/metabolism , Pancreatitis/chemically induced , Rats
19.
Arch Biochem Biophys ; 376(1): 59-65, 2000 Apr 01.
Article in English | MEDLINE | ID: mdl-10729190

ABSTRACT

The key technique in proteome analysis is high-resolution two-dimensional (2D) electrophoretic separation of proteins from biological samples. This method combines isoelectric focusing (IEF) and sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Derivatization of protein carbonyls with 2, 4-dinitrophenylhydrazine (DNPH) and subsequent anti-dinitrophenyl (DNP) immunoblotting is widely used for the detection of oxidatively modified proteins. In previous studies on adapting this method to 2D electrophoresis the derivatization step was carried out before and after the 2D procedure, resulting in an altered spot pattern and high background staining, respectively. The aim of the present experiments was to develop a method for protein derivatization with DNPH between the IEF and the SDS-PAGE steps. Mitochondria were exposed to 10 min hypoxia and 5 min reoxygenation. After IEF using immobilized pH gradients the gel strips were incubated in DNPH/trifluoroacetic acid/SDS for 20 min and neutralized, and SDS-PAGE was performed. Proteins were either stained with Coomassie dye or subjected to Western blotting using anti-DNP IgG. Gels and blots were scanned and matched to a master gel, and the relative carbonyl content of each spot was calculated and compared for five experiments. Importantly, the spot patterns in DNPH-treated and untreated gels were not different. Protein carbonyls could be detected in 59 of the 125 matched spots. Although there was no significant increase in the total protein carbonyl content after hypoxia/reoxygenation, eighteen 2D spots exhibited an increase in carbonyl content. However, most protein spots did not show a change or even a decline (4 spots) in protein carbonyls.


Subject(s)
Hypoxia/metabolism , Mitochondria, Liver/metabolism , Proteins/chemistry , Proteins/metabolism , Proteome/analysis , Proteome/metabolism , Animals , Electrophoresis, Polyacrylamide Gel , Evaluation Studies as Topic , Hydrogen-Ion Concentration , In Vitro Techniques , Indicators and Reagents , Isoelectric Focusing , Male , Oxygen/metabolism , Phenylhydrazines , Rats , Rats, Wistar
20.
Surg Endosc ; 14(12): 1180-4, 2000 Dec.
Article in English | MEDLINE | ID: mdl-11148794

ABSTRACT

BACKGROUND: Clinical trials have found that the pneumoperitoneum has potentially hazardous side effects. The biochemical basis of organ injury induced by pneumoperitoneum is, however, not well defined. Since oxidative stress is believed to play an important role in many pathological conditions, we set out to examine oxidative stress markers in the lung, liver, kidney, and pancreas by using a rat model of laparoscopy with CO(2) pneumoperitoneum and comparing it to a group with gasless laparoscopy. METHODS: Malondialdehyde (for lipid peroxidation), protein-bound carbonyls (for protein oxidation), reduced and oxidized glutathione, and the neutrophil marker myeloperoxidase were evaluated in tissue homogenates at 2 h, 6 h, and 18 h after laparoscopy. Immunoblotting was used to analyze the modification of lung proteins by 4-hydroxynonenal at 6 h. RESULTS: Significant lipid peroxidation was found selectively in lungs at 2 h and 6 h after CO(2) pneumoperitoneum. This was accompanied by a loss of glutathione but only minor protein oxidation. Further, lung proteins were clearly modified by the aldehydic product of lipid peroxidation 4-hydroxynonenal. Myeloperoxidase in lungs increased continuously up to 18 h in both experimental groups, but there were higher levels in the group with pneumoperitoneum. CONCLUSION: Oxidative stress is likely to contribute to the impairment of pulmonary function after laparoscopic operations using a CO(2) pneumoperitoneum.


Subject(s)
Carbon Dioxide/adverse effects , Lung/metabolism , Oxidative Stress/physiology , Pneumoperitoneum, Artificial/adverse effects , Analysis of Variance , Animals , Kidney/drug effects , Kidney/metabolism , Laparoscopy , Lipid Peroxidation/drug effects , Liver/drug effects , Liver/metabolism , Lung/drug effects , Male , Oxidative Stress/drug effects , Pancreas/drug effects , Pancreas/metabolism , Pneumoperitoneum, Artificial/methods , Rats , Rats, Wistar , Statistics, Nonparametric , Time Factors
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