Local and systemic effects of aging on acute pancreatitis.

BACKGROUND: /Objectives: Evaluation of the local and systemic effects of aging on the severity of acute pancreatitis (AP) in an experimental rat model in elderly animals. METHODS: AP was induced in Wistar rats by intraductal 2.5% taurocholate injection and divided into two groups: Young (3 month old) and Aged (18 month old). Two and 24 h after AP induction blood samples were collected for determinations of amylase, AST, ALT, urea, creatinine, glucose, and of plasma I-FABP. TNF-α and IL-6 levels were determined in serum and ascitic fluid. Liver mitochondrial function and malondialdehyde (MDA) contents, pancreas histological analysis, and pulmonar myeloperoxidade (MPO) activity were performed. Bacterial translocation was evaluated by bacterial cultures of pancreas. RESULTS: A significant increase in serum amylase, AST, ALT, urea, creatinine, glucose, I-FABP, and IL-6 levels, and a reduction in serum and ascitic fluid TNF-α levels were observed in the aged group compared to the young group. Liver mitochondrial dysfunction, MDA contents, and pulmonary MPO activity were increased in the Aged AP group compared to the Young AP group. Positive bacterial cultures obtained from pancreas tissue in aged group were significantly increased compared to the young group. Acinar necrosis was also increased in aged AP group when compared to young AP group. CONCLUSION: Aging worsens the course of acute pancreatitis evidenced by increased local and systemic lesions and increased bacterial translocation.

Mechanisms of the beneficial effect of sevoflurane in liver ischemia/reperfusion injury.

PURPOSE: To evaluate the underlying mechanisms by which sevoflurane protects the liver against ischemia/reperfusion injury evaluate the mechanism by which sevoflurane exerts this protective effect. METHODS: Twenty-six rats were subjected to partial ischemia/reperfusion injury for 1h: one group received no treatment, one group received sevoflurane, and sham group of animals received laparotomy only. Four hours after reperfusion, levels of alanine and aspartate aminotransferases, tumor necrosis factor-a, and interleukins 6 and 10 were measured. Analyses of mitochondrial oxidation and phosphorylation, malondialdehyde content, histology, and pulmonary vascular permeability were performed. RESULTS: Serum levels of alanine and aspartate aminotransferases were significantly lower in the sevoflurane group compared to untreated controls (p<0.05). The sevoflurane group also showed preservation of liver mitochondrial function compared to untreated controls (p<0.05). Sevoflurane administration did not alter increases in serum levels of tumor necrosis factor-a, and interleukins 6 and 10. Sevoflurane treatment significantly reduced the coagulative necrosis induced by ischemia/reperfusion (p<0.05). Pulmonary vascular permeability was preserved in the sevoflurane group compared to untreated controls. CONCLUSION: Sevoflurane administration protects the liver against ischemia/reperfusion injury, via preservation of mitochondrial function, and also preserves lung vascular permeability.

Mechanisms of the beneficial effect of sevoflurane in liver ischemia/reperfusion injury

To evaluate the underlying mechanisms by which sevoflurane protects the liver against ischemia/reperfusion injury evaluate the mechanism by which sevoflurane exerts this protective effect. METHODS: Twenty-six rats were subjected to partial ischemia/reperfusion injury for 1h: one group received no treatment, one group received sevoflurane, and sham group of animals received laparotomy only. Four hours after reperfusion, levels of alanine and aspartate aminotransferases, tumor necrosis factor-a, and interleukins 6 and 10 were measured. Analyses of mitochondrial oxidation and phosphorylation, malondialdehyde content, histology, and pulmonary vascular permeability were performed. RESULTS: Serum levels of alanine and aspartate aminotransferases were significantly lower in the sevoflurane group compared to untreated controls (p 0.05). The sevoflurane group also showed preservation of liver mitochondrial function compared to untreated controls (p 0.05). Sevoflurane administration did not alter increases in serum levels of tumor necrosis factor-a, and interleukins 6 and 10. Sevoflurane treatment significantly reduced the coagulative necrosis induced by ischemia/reperfusion (p 0.05). Pulmonary vascular permeability was preserved in the sevoflurane group compared to untreated controls. CONCLUSION: Sevoflurane administration protects the liver against ischemia/reperfusion injury, via preservation of mitochondrial function, and also preserves lung vascular permeability.(AU)

Mechanisms of the beneficial effect of sevoflurane in liver ischemia/reperfusion injury

PURPOSE: To evaluate the underlying mechanisms by which sevoflurane protects the liver against ischemia/reperfusion injury evaluate the mechanism by which sevoflurane exerts this protective effect. METHODS: Twenty-six rats were subjected to partial ischemia/reperfusion injury for 1h: one group received no treatment, one group received sevoflurane, and sham group of animals received laparotomy only. Four hours after reperfusion, levels of alanine and aspartate aminotransferases, tumor necrosis factor-a, and interleukins 6 and 10 were measured. Analyses of mitochondrial oxidation and phosphorylation, malondialdehyde content, histology, and pulmonary vascular permeability were performed. RESULTS: Serum levels of alanine and aspartate aminotransferases were significantly lower in the sevoflurane group compared to untreated controls (p<0.05). The sevoflurane group also showed preservation of liver mitochondrial function compared to untreated controls (p<0.05). Sevoflurane administration did not alter increases in serum levels of tumor necrosis factor-a, and interleukins 6 and 10. Sevoflurane treatment significantly reduced the coagulative necrosis induced by ischemia/reperfusion (p<0.05). Pulmonary vascular permeability was preserved in the sevoflurane group compared to untreated controls. CONCLUSION: Sevoflurane administration protects the liver against ischemia/reperfusion injury, via preservation of mitochondrial function, and also preserves lung vascular permeability.

Beneficial effects of adenosine triphosphate-sensitive K+ channel opener on liver ischemia/reperfusion injury.

AIM: To investigate the effect of diazoxide administration on liver ischemia/reperfusion injury. METHODS: Wistar male rats underwent partial liver ischemia performed by clamping the pedicle from the medium and left anterior lateral segments for 1 h under mechanical ventilation. They were divided into 3 groups: Control Group, rats submitted to liver manipulation, Saline Group, rats received saline, and Diazoxide Group, rats received intravenous injection diazoxide (3.5 mg/kg) 15 min before liver reperfusion. 4 h and 24 h after reperfusion, blood was collected for determination of aspartate transaminase (AST), alanine transaminase (ALT), tumor necrosis factor (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), nitrite/nitrate, creatinine and tumor growth factor-ß1 (TGF-ß1). Liver tissues were assembled for mitochondrial oxidation and phosphorylation, malondialdehyde (MDA) content, and histologic analysis. Pulmonary vascular permeability and myeloperoxidase (MPO) were also determined. RESULTS: Four hours after reperfusion the diazoxide group presented with significant reduction of AST (2009 ± 257 U/L vs 3523 ± 424 U/L, P = 0.005); ALT (1794 ± 295 U/L vs 3316 ± 413 U/L, P = 0.005); TNF-α (17 ± 9 pg/mL vs 152 ± 43 pg/mL, P = 0.013; IL-6 (62 ± 18 pg/mL vs 281 ± 92 pg/mL); IL-10 (40 ± 9 pg/mL vs 78 ± 10 pg/mL P = 0.03), and nitrite/nitrate (3.8 ± 0.9 µmol/L vs 10.2 ± 2.4 µmol/L, P = 0.025) when compared to the saline group. A significant reduction in liver mitochondrial dysfunction was observed in the diazoxide group compared to the saline group (P < 0.05). No differences in liver MDA content, serum creatinine, pulmonary vascular permeability and MPO activity were observed between groups. Twenty four hours after reperfusion the diazoxide group showed a reduction of AST (495 ± 78 U/L vs 978 ± 192 U/L, P = 0.032); ALT (335 ± 59 U/L vs 742 ± 182 U/L, P = 0.048), and TGF-ß1 (11 ± 1 ng/mL vs 17 ± 0.5 ng/mL, P = 0.004) serum levels when compared to the saline group. The control group did not present alterations when compared to the diazoxide and saline groups. CONCLUSION: Diazoxide maintains liver mitochondrial function, increases liver tolerance to ischemia/reperfusion injury, and reduces the systemic inflammatory response. These effects require further evaluation for using in a clinical setting.

Nitric oxide synthase inhibition reduces albumin induced lung damage in acute pancreatitis.

BACKGROUND/OBJECTIVES: Colloid resuscitation in acute pancreatitis (AP) is a matter of controversy due to the possible deleterious effect on lung function. A previous study demonstrates that albumin administration increases lung damage in burns and this effect can be reversed by inducible nitric oxide synthase (iNOS) inhibition. This study evaluates the effects of S-methylisothiourea (SMT), a specific iNOS inhibitor, on lungs and pancreas of rats with AP receiving intravenous albumin. METHODS: AP was induced in Wistar rats by intraductal 5% taurocholate injection. To evaluate the effect of albumin on lung damage, animals received IV saline or human albumin immediately after AP (Groups: Saline and Albumin). To evaluate the effect of iNOS inhibition on lung damage, SMT was given immediately after AP (Group Saline+SMT, and Group Albumin+SMT). At 12 h after AP induction, serum amylase activity, lung vascular permeability and myeloperoxidase (MPO) activity were evaluated. Lung and pancreas histological analysis were performed. RESULTS: Serum amylase activity, pancreatic edema, lung vascular permeability, MPO activity, and inflammatory infiltration were significantly increased after AP. Albumin administration increased lung vascular permeability, inflammatory infiltration, and pancreatic edema compared to saline administration (p < 0.05). Albumin administration with SMT reduced lung vascular permeability, MPO activity, and inflammatory infiltration compared to albumin administration alone (p < 0.05). CONCLUSION: Lung and pancreatic damage induced by albumin administration for restoration of plasma volume in AP are reduced by iNOS inhibition. Awareness of this fact may be useful in high-risk patients who need to receive albumin for volume replacement.

Pentoxifylline improves liver regeneration through down-regulation of TNF-α synthesis and TGF-ß1 gene expression.

AIM: To investigate the mechanism of pentoxifylline (PTX) improvement in liver regeneration. RESULTS: Rats were randomized into 4 groups: Control rats; Sham - sham-operation rats; Saline - 70% hepatectomy plus saline solution; PTX - 70% hepatectomy plus PTX. At 2 and 6 h after hepatectomy, aspartate aminotransferase, alanine aminotransferase, tumor necrosis factor (TNF)-α and interleukin-6 (IL-6) serum and hepatic tissue levels were determined. Tumor growth factor (TGF)-ß1 gene expression in liver tissue was evaluated 24 h after hepatectomy by quantitative reverse transcriptase polymerase chain reaction analysis. Proliferation was analyzed by mitotic index and proliferating cell nuclear antigen (PCNA) staining 48 h after hepatectomy. RESULTS: TNF-α and IL-6 serum levels increased at 2 and 6 h after hepatectomy. At 2 h after hepatectomy serum PTX was reduced but not hepatic levels of TNF-α and IL-6. A decrease in liver TGF-ß1 gene expression and an increase in mitotic index and PCNA after hepatectomy were observed in the PTX treatment group in comparison to the saline group. CONCLUSION: PTX improves liver regeneration by a mechanism related to down regulation of TNF-α production and TGF-ß1 gene expression.

Timing-dependent protection of hypertonic saline solution administration in experimental liver ischemia/reperfusion injury.

BACKGROUND: During liver ischemia, the decrease in mitochondrial energy causes cellular damage that is aggravated after reperfusion. This injury can trigger a systemic inflammatory syndrome, also producing remote organ damage. Several substances have been employed to decrease this inflammatory response during liver transplantation, liver resections, and hypovolemic shock. The aim of this study was to evaluate the effects of hypertonic saline solution and the best timing of administration to prevent organ injury during experimental liver ischemia/reperfusion. METHODS: Rats underwent 1 hr of warm liver ischemia followed by reperfusion. Eighty-four rats were allocated into 6 groups: sham group, control of ischemia group (C), pre-ischemia treated NaCl 0.9% (ISS) and NaCl 7.5% (HTS) groups, pre-reperfusion ISS, and HTS groups. Blood and tissue samples were collected 4 hr after reperfusion. RESULTS: HTS showed beneficial effects in prevention of liver ischemia/reperfusion injury. HTS groups developed increases in AST and ALT levels that were significantly less than ISS groups; however, the HTS pre-reperfusion group showed levels significantly less than the HTS pre-ischemia group. No differences in IL-6 and IL-10 levels were observed. A significant decrease in mitochondrial dysfunction as well as hepatic edema was observed in the HTS pre-reperfusion group. Pulmonary vascular permeability was significantly less in the pre-reperfusion HTS group compared to the ISS group. No differences in myeloperoxidase activity were observed. The liver histologic score was significantly less in the pre-reperfusion HTS group compared to the pre-ischemia HTS group. CONCLUSION: HTS ameliorated local and systemic injuries in experimental liver ischemia/reperfusion. Infusion of HTS in the pre-reperfusion period may be an important adjunct to accomplish the best results.

Statin pretreatment in experimental acute pancreatitis.

CONTEXT: Some authors have found beneficial effect of statins in certain inflammatory conditions, but the effect of statins on acute pancreatitis is not yet defined. OBJECTIVE: The aim of this study was to evaluate the effect of simvastatin on an experimental model of mild and severe acute pancreatitis. ANIMALS: One hundred and one Wistar rats with cerulein or taurocholate-induced acute pancreatitis were used in this study. DESIGN: The rats were divided into two groups: Group I (n=51) received two previously i.p. injections (18+/-2 and 3+/-1 hours) of simvastatin (200 microg/kg) and Group II (n=50) received two previously i.p. injections of saline. Both groups were subdivided into two subgroups: mild pancreatitis (cerulein-induced; IA, n=10; IIA, n=10) and severe pancreatitis (taurocholate-induced; IB, n=41; IIB, n=40). MAIN OUTCOME MEASURES: The parameters evaluated were: pancreatic vascular permeability, tissue water content, histologic lesion, amylase serum levels in rats with mild pancreatitis (subgroups A); mortality rate, serum levels of IL-6, IL-10, amylase, pulmonary myeloperoxidase activity and ascitic levels of TNF-alpha in rats with severe pancreatitis (subgroups B). RESULTS: Serum levels of IL-10 were significantly lower in the simvastatin-treated group as well as the myeloperoxidase activity. There was no significant difference in any of other studied parameters. CONCLUSION: Simvastatin appears to reduce inflammatory cytokines and pulmonary neutrophilic activation in the severe acute pancreatitis model, but there is no significant effect on survival curve, in spite of a clear trend towards a better survival in the simvastatin group.

Effect of hyperthermia on experimental acute pancreatitis

BACKGROUD: Recent studies indicate that hyperthermia can change inflammatory mechanisms and protect experimental animals from deleterious effects of secretagogue-induced acute pancreatitis AIM: To evaluate the effects of hyperthermia post-treatment on cerulein-induced acute pancreatitis in rats METHODS: Twenty animals were divided in two groups: group I (n = 10), rats with cerulein-induced acute pancreatitis undergone hyperthermia, and group II (n = 10), animals with cerulein-induced acute pancreatitis that were kept normothermic. In all groups, amylase serum levels, histologic damage, vascular permeability and pancreatic water content were assessed. Acute pancreatitis was induced by administration of two cerulein injections (20 mcg/kg). A single dose of Evans' blue dye was administered along with the second dose of cerulein. All animals also received a subcutaneous injection of saline solution. After this process, animals undergone hyperthermia were heated in a cage with two 100 W lamps. Body temperature was increased to 39.5°C and maintained at that level for 45 minutes. Normothermia rats were kept at room temperature in a second cage RESULTS: Control animals had typical edema, serum amylase activity and morphologic changes of this acute pancreatitis model. Hyperthermia post-treatment ameliorated the pancreatic edema, whereas the histologic damage and the serum amylase level remained unchanged CONCLUSIONS: The findings suggest a beneficial effect of the thermal stress on inflammatory edema in experimental acute pancreatitis.

RACIONAL: Estudos recentes indicam que a hipertermia pode modificar mecanismos inflamatórios e proteger animais experimentais dos efeitos deletérios da pancreatite aguda induzida por secretagogos OBJETIVO: Avaliar a eficácia da hipertermia como tratamento da pancreatite aguda induzida por ceruleína em ratos MÉTODOS: Vinte animais foram divididos em dois grupos: grupo I (n = 10), ratos com pancreatite aguda induzida por ceruleína e submetidos a hipertermia, e grupo II (n = 10), animais com pancreatite aguda induzida por ceruleína mantidos em normotermia. Em todos os grupos foram medidos níveis séricos de amilase, histologia, permeabilidade vascular e conteúdo de água do pâncreas. A pancreatite aguda foi induzida através da administração de duas injeções de ceruleína (20 mcg/ kg). Dose única do corante azul de Evans foi administrada juntamente com a segunda injeção de ceruleína. Todos os animais também receberam 5 mL de solução salina subcutânea. Após a indução, os animais do grupo hipertérmico foram aquecidos com duas lâmpadas de 100 W em gaiola parcialmente isolada. A temperatura corporal foi aumentada para 39,5°C e mantida neste nível por 45 minutos. Os animais controle foram mantidos em uma segunda gaiola em temperatura ambiente RESULTADOS: Os animais controle tiveram edema, danos histológicos e níveis de amilase típicos do modelo de pancreatite aguda leve com ceruleína. O tratamento com hipertermia melhorou o edema pancreático porém não teve efeito nos nível séricos de amilase e no dano histológico pancreático CONCLUSÕES: Os resultados sugerem efeito benéfico da hipertermia no edema inflamatório da pancreatite aguda leve experimental.

Effect of hyperthermia on experimental acute pancreatitis.

BACKGROUND: [corrected] Recent studies indicate that hyperthermia can change inflammatory mechanisms and protect experimental animals from deleterious effects of secretagogue-induced acute pancreatitis AIM: To evaluate the effects of hyperthermia post-treatment on cerulein-induced acute pancreatitis in rats METHODS: Twenty animals were divided in two groups: group I (n = 10), rats with cerulein-induced acute pancreatitis undergone hyperthermia, and group II (n = 10), animals with cerulein-induced acute pancreatitis that were kept normothermic. In all groups, amylase serum levels, histologic damage, vascular permeability and pancreatic water content were assessed. Acute pancreatitis was induced by administration of two cerulein injections (20 mcg/kg). A single dose of Evans' blue dye was administered along with the second dose of cerulein. All animals also received a subcutaneous injection of saline solution. After this process, animals undergone hyperthermia were heated in a cage with two 100 W lamps. Body temperature was increased to 39.5 degrees C and maintained at that level for 45 minutes. Normothermia rats were kept at room temperature in a second cage RESULTS: Control animals had typical edema, serum amylase activity and morphologic changes of this acute pancreatitis model. Hyperthermia post-treatment ameliorated the pancreatic edema, whereas the histologic damage and the serum amylase level remained unchanged CONCLUSIONS: The findings suggest a beneficial effect of the thermal stress on inflammatory edema in experimental acute pancreatitis.

Influence of pancreatic enzyme content on experimental acute pancreatitis.

INTRODUCTION: Some studies demonstrate the crucial role of proteases in the pathogenesis of acute pancreatitis (AP). Systemic release of proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) has been demonstrated in AP, yet the mechanism of activation remains unclear. Furthermore, it is not known if the amount of pancreatic enzyme in the pancreas determines the production of proinflammatory cytokines. AIM: To determine whether there is a link between the pancreatic enzyme content and the production of cytokines and consequently the systemic lesions observed in AP. METHODOLOGY: Forty-seven animals were divided into three groups: group I had a high pancreatic enzyme level (with and without AP), group II had a low pancreatic enzyme level (cerulein infusion: 0.133 microg x kg(-1) x h(-1)) (with and without AP), and group III were the controls. AP was induced by injection of 5% sodium taurocholate into the pancreatic duct. To evaluate the pancreatic enzyme contents before AP, trypsinogen and amylase analysis was carried out on pancreatic tissue collected after the animals were killed. Two hours after induction of AP, concentrations of pancreatic enzymes and trypsinogen activation peptide (TAP) in serum, ascitic fluid, and pancreatic tissue were determined. The ascitic fluid was assayed for TNF-alpha and the serum was assayed for IL-6 with ELISA kits. Systemic lesions were sought on the basis of hepatic mitochondrial respiratory function measured polarographically. RESULTS AND CONCLUSION: The administration of physiological doses of cerulein diminishes the pancreatic enzyme and TAP levels, the production of proinflammatory cytokines, and the liver mitochondrial dysfunction observed in AP, suggesting that the pancreatic enzyme content is an important factor in the severity of AP.

Efeito do antioxidante N2-mercaptopropionilglicina (N2-MPG) na pancreatite aguda experimental / N2-Mercaptopropionylglycine (N2 MPG) in experimental acute pancreatitis

O N2-Mercaptopropionilglicina (MPG) e um potente antioxidante na inibicao da producao de xantina-oxidase. O objetivo deste trabalho foi analisar se este efeito antioxidante poderia propiciar menor agressao do tecido pancreatico na Pancreatite Aguda (PA) induzida por dois processos: dose supramaxima de ceruleina e injecao de taurocolato de sodio a 2,5 por cento no ducto biliopancreatico do rato. Trinta e seis ratos machos Wistar (220-270 g) foram divididos em 2 grupos (G): GI-animais previamente tratados com antioxidante (MPG: 100 mg/kg) 10 minutos antes da inducao da PA e GII-animais sem tratamento previo. Os animais destes dois grupos foram submetidos a PA com dose supramaxima de ceruleina (2 doses de 20ug/kg) e PA com taurocolato onde vinte e seis ratos foram divididos em dois grupos (G): GIII-ratos tratados com MPG 10 minutos antes da PA e GIV-animais sem tratamento previo...

Lesäo hepatica na pancreatite aguda experimental: influencia da reduçäo da reserva enzimatica do pancreas / Evaluation of hepatic lesion of experimental acute pancreatitis: influence of pancreatic enzyme reduction

A pancreatite aguda (PA) produz alteracoes morfologicas e funcionais no figado. A administraçäo de doses baixas de ceruleina diminui o conteudo enzimatico do pancreas. O objetivo do presente estudo foi estudar o efeito da reduçäo do conteudo enzimatico do pancreas na funçäo mitocondrial hepatica. Ratos machos Wistar foram submetidos a PA atraves de injeçäo retrograda intraductal de taurocolato de sodio a 5 por cento com e sem infusäo de ceruleina (0,133 ug/Kg/h) durante tres horas : Grupo I (GI): sem reducao enzimatica do pancreas, com induçäo de PA, GRUPO II (GII): com reduçäo enzimática do pancreas, com induçäo de PA, GRUPO III (GIII): com reduçäo enzimatica do pancreas, sem induçäo de PA, GRUPO IV (GIV): sem reduçäo enzimatica do pancreas, sem induçäo de PA (Controle). Após duas horas da inducao da PA os animais foram sacrificados e os figados retirados para avaliaçäo da funçäo mitocondrial hepatica, determinada polarograficamente com eletrodo de Clark, medindo-se o consumo de oxigenio na ausência de ADP (S4-Basal) e na presença de ADP (S-3 Ativado), utilizando-se succinato de potassio como substrato. Os conteudos de tripsina, amilase e proteinas totais no liquido ascitico foram determinados. Após duas horas da induçäo da PA observamos aumento significativo no estado 4 da respiraçäo (41 por cento) e diminuiçäo do RCR e da relaçäo ADP/O nos animais do GI (PA sem ceruleina) quando comparados com os animais do GII (PA com ceruleina) (p<0,05). O conteudo de amilase (A) e tripsina (T) no liquido ascitico mostraram-se diminuidos nos animais do GII (A=80 +- 10 U/ml, T= 9,75 +- 1,25 U/ml), quando comparados com os animais do GI que nao receberam ceruleina ( A= 231 +- 24 U/ml, T = 40,32 +- 5,19 U/ml) (p<0,001). Infusäo somente de ceruleina (GIII) näo alterou a funçäo mitocondrial hepatica. Estes achados sugerem que a reduçäo do conteudo enzimatico do pancreas através de infusäo de ceruleina atenua a disfunçäo mitocondrial hepatica na PA experimental evidenciada por desacoplamento da oxigenaçäo fosforilativa

Fisiopatologia da lesao pulmonar na pancreatite aguda / Physiopathology of pancreatitis lung injury

Sinais clinicos de lesao pulmonar desenvolvem-se em ate 50 a 70 por cento dos pacientes com pancreatite aguda. A despeito disto, a fisiopatologia da lesao pulmonar na pancreatite aguda nao esta totalmente compreendida ate o momento. O edema pulmonar e a principal complicacao respiratoria da pancreatite aguda. A permeabilidade aumentada das membranas endotelial pulmonar e epitelial alveolar sao as causas do edema pulmonar. Varios fatores tem sido apontados como causadores do edema pulmonar: liberacao de enzimas pancreaticas proteoliticas, radicais livres de oxigenio, fosfolipase A, acidos graxos livres, fator de necrose tumoral, fator ativador lactario, metabolitos do acido aracdonico e microembolizacao pulmonar. A compreensao da fisiopatologia da lesao pulmonar faculta ao medico uma melhor abordagem terapeutica dos pacientes com pancreatite aguda. O objetivo deste trabalho e expor as teorias que explicam a lesao pulmonar da pancreatite aguda

Efeito protetor da reduçäo do conteúdo enzimático do pâncreas na lesäo pulmonar da pancreatite aguda / Protective effect of reduction of pancreatic enzyme content on the pancreas in acute pulmonary pancreatitis

A lesao pulmonar surge em até 50-70 por cento dos pacientes com pancreatite aguda. A infusao de ceruleína em doses fisiológicas reduz o conteúdo enzimático do pâncreas com diminuiçao da taxa de mortalidade da pancreatite. Com objetivo de avaliar o efeito da reduçao do conteúdo enzimático do pâncreas sobre a lesao pulmonar da pancreatite aguda, foi induzida pancreatite em ratos Wistar através da infusao, dentro do ducto biliar, de soluçao de taurocolato de sódio a 5 por cento: grupo I, ratos com pancreatite; grupo II, ratos nos quais pancreatite foi induzida somente após reduçao do conteúdo enzimático do pâncreas, e grupo III, controle. A lesao pulmonar foi avaliada através da utilizaçao do corante azul de Evans, sendo menor no grupo II comparativamente ao I (P O,05). Especula-se que a reduçao do conteúdo enzimático do pâncreas diminui a lesao pulmonar da pancreatite aguda pela reduçao da quantidade de enzimas que atinge a circulaçao sistêmica.

Translocaçäo bacteriana na pancreatite aguda: estudo experimental em ratos / Bacterial translocation during acute pancreatitis in rats

O intestino tem sido responsabilizado como fonte de infecçäo na pancreatite aguda. A translocaçäo bacteriana para linfonodos mesentericos, pancreas cavidade e sangue foi analisada com 6 h, 24 h, 48 h e 96 h após induçäo de pancreatite aguda näo letal em 90 ratos Wistar. Observou-se crescimento bacteriano em 60 por cento (6 h), 90 por cento (24 h), 70 por cento (48 h) e 40 por cento (96 h) dos linfonodos mesentericos (p<0,05). Os pâncreas foram colonizados em 67 por cento (6 h), 90 por cento (24 h), 50 por cento (48 h) e 40 por cento (96 h) (p<0,05). As bactérias Gram-positivas foram mais frequentes que as Gram-negativas no periodo de 6 h, enquanto que, as bactérias Gram-negativas predominaram no periodo de 24 a 96 horas. A bacteria isolada mais frequentemente foi a Escherichia coli. Näo houve aumento da populaçäo bacteriana cecal...

Lesão pulmonar na pancreatite aguda. Influência da redução do conteúdo enzimático do pâncreas / Lung injury in acute pancreatitis. Influence of pancreatic enzymes reduction

A previous report has show that cerulein in physiological doses reduces the rate mortality of pancreatitis by decreasing the enzyme content of the pancreas. Clinically detectable signs of lung injury develop in up to 50-70 percent of patients with acute pancreatitis. The aim of the present study was to assess the effect of acute reduction of pancreatic enzyme content on the pancreatitis pulmonary injury. Experimental haemorrhagic pancreatitis was induced by intraductal injection of 5 per cent sodium taurocholate in two groups of Wistar rats: group I (pancreatitis) and group II (pancreatitis after decreasing pancreatic enzyme content). Dye Evans blue was used to evaluate the lung injury. The degree of histologically observed lesions were similar in both groups, but the pulmonary lesion was smaller in group II than group I (p < 0.05). In conclusion: 1) pancreatitis' pulmonary lesion may be related with pancreatic enzymes that reach the blood stream and 2) the reduction of the pancreatic enzyme content has a beneficial effect on acute pancreatitis and reduces its pulmonary injury.

Lesao pulmonar na pancreatite aguda / Lung injury in acute pancreatitis

Lesao pulmonar surge em ate 70 por cento dos pacientes com pancreatite aguda. O objetivo deste trabalho e de estudar a lesao pulmonar na pancreatite aguda experimental. Assim, pancreatite grave foi induzida em 63 ratos atraves da injecao de taurocolato de sodio a 5 por cento no ducto bilio-pancreatico. Apos 2, 4, 6, 12, 24 e 48 horas da inducao, foram realizadas as investigacoes. A lesao pulmonar foi maxima apos 12 horas de pancreatite, as enzimas pancreaticas (amilase e tripsina) no liquido ascitico estavam mais elevadas precocemente (2-4h) e os niveis sericos foram maiores no tempo de quatro horas. Conclue-se que na pancreatite aguda experimental ocorre lesao pulmonar com aumento da permeabilidade vascular pulmonar. Esta lesao e maxima no tempo de 12 h e tem relacao com os niveis das enzimas pancreaticas no liquido peritonial e no soro.

Modelo simplificado de inducao de pancreatite aguda experimental com uso de dose supramaxima de ceruleina / Simplified model of produced experimental acute pancreatitis with use of supra-maximal dosis of cerulein

A administracao de ceruleina tanto por via endovenosa como intraperitonial, tem sido extensivamente utilizada para inducao de pancreatite aguda experimental. Com objetivo de se testar uma nova metodologia de inducao de pancreatite aguda, que fosse de facil e rapida execucao, assim como de boa reprodutibilidade , 40 ratos Wistar foram distribuidos em quatro grupos: GRUPO I - animais que receberam infusao continua de ceruleina (15µ/Kg) GRUPO II - animais que receberam infusao continua e salina GRUPO III - animais submetidos a duas injecoes (SC+CV) de ceruleina (40µ/Kg) GRUPO IV - animais submetidos a duas injecoes (SC+CV) de salina. Apos a realizacao de dosagens bioquimicas, nao houve diferenca estatisticamente significativa entre os grupos I e II nas concentracoes teciduaias de tripsionogenio, quimiotripsinogenio, proelastase , catepsina e tambem amilase serica; ocorrendo diferenca somente entre os valores de porcentagem de agua no tecido pancreatico...