Importance of Cytokines, Nitric Oxide, and Apoptosis in the Pathological Process of Necrotizing Pancreatitis in Rats

Lénárd, László; Morschl, Éva; László, Ferenc; Mándi, Yvette; Takács, Tamás; Jármai, Katalin; Farkas, Gyula

doi:10.1097/00006676-200408000-00011

Cited by 65 publications

(38 citation statements)

References 24 publications

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“…The pathophysiology of ARDS is described as increased pulmonary vasculature leaking protein-rich transudate into the alveolar space and decreased lung compliance clinically manifested as refractory hypoxemia, and radiologically as diffuse infiltration in the lungs. In the pathogenesis of systemic complications of pancreatitis, the role of active enzymes in circulation, the liberation of proinflammatory cytokines, decreased nor mal defense mechanisms, and the increased production of nitric oxide have been studied [25,26] . The mortality and severity of the disease appear to be influenced by events occurring subsequent to the pancreatic injury as a result of the release of cytokines and other mediators.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes in patients with ICU-related pancreatitis

Tseng

Fang²,

Chung³

et al. 2009

WJG

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AIM:To identify risk factors predictive of intensive care unit (ICU) mortality in patients with ventilatorrelated pancreatitis. The clinical outcomes of patients with ventilator-related pancreatitis were compared with those of patients with pancreatitis-related respiratory failure as well as controls. METHODS:One hundred and forty-eight patients with respiratory failure requiring mechanical ventilation and concomitant acute pancreatitis were identified from a prospectively collected dataset of 9108 consecutive patients admitted with respiratory failure over a period of five years. Sixty patients met the criteria for ventilator-related pancreatitis, and 88 (control patients), for pancreatitis-related respiratory failure. RESULTS:Mortality rate in ventilator-related pancreatitis was comparable to that in ICU patients without pancreatitis by case-control methodology (P = 0.544). Multivariate logistic regression analysis identified low PaO2/FiO2 (OR: 1.032, 95% CI: 1.006-1.059, P = 0.016) as an independent risk factor for mortality in patients with ventilator-related pancreatitis. The mortality rate in patients with ventilator-related pancreatitis was lower than that in patients with acute pancreatitis-related respiratory failure (P < 0.001). CONCLUSION:We found that low PaO2/FiO2 was an independent clinical parameter predictive of ICU mortality in patients with ventilator-related pancreatitis.

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes in patients with ICU-related pancreatitis

Tseng

Fang²,

Chung³

et al. 2009

WJG

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“…In FolchPuy's experiment, infusion of a contrast medium into the pancreatic duct could result in an inflammatory process characterized by increased lipase levels in plasma and edema as well as increased myeloperoxidase activity in pancreas, suggesting that activation of NF-kappaB is correlated with iNOS expression in pancreatic cells [17] . It was reported that ischemia/reperfusion provokes severe acute necrotizing pancreatitis with a high mortality rate and leads to systemic inflammatory reaction due to the activation of cytokine cascade and iNOS, indicating that NO overproduction by iNOS corresponds with the apoptotic process in the pancreas and the lung [18,19] . In a study on ischemia/ reperfusion injury, Duchen found that calcium overload is associated with NO generation, and their combination leads to collapse of mitochondrial membrane potential followed by cell death [20] .…”

Section: Discussionmentioning

confidence: 99%

Protective effect of inducible nitric oxide synthase inhibitor on pancreas transplantation in rats

Bai-Feng¹,

Li²,

Yongfeng³

et al. 2007

WJG

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AIM:To investigate the effect of inducible nitric oxide synthase inhibitor, aminoguanidine, on pancreas transplantation in rats. METHODS:A model of pancreas transplantation was established in rats. Streptozotocin-induced diabetic male Wistar rats were randomly assigned to sham-operation control group (n = 6), transplant control group (n = 6), and aminoguanidine (AG) treatment group (n = 18). In the AG group, aminoguanidine was added to intravascular infusion as the onset of reperfusion at the dose of 60 mg/kg, 80 mg/kg, 100 mg/kg body weight, respectively. Serum nitric oxide (NO) level, blood sugar and amylase activity were detected. Nitric oxide synthase (NOS) test kit was used to detect the pancreas cNOS and inducible NOS (iNOS) activity. Pancreas sections stained with HE and immunohistochemistry were evaluated under a light microscope. RESULTS:As compared with the transplant control group, the serum NO level and amylase activity decreased obviously and the evidence for pancreas injury was much less in the AG group. The AG (80 mg/kg body weight) group showed the most significant difference in NO and amylase (NO: 66.0 ± 16.6 vs 192.3 ± 60.0, P < 0.01 and amylase: 1426 ± 177 vs 4477 ± 630, P < 0.01).The expression and activity of tissue iNOS, and blood sugar in the AG (80 mg/kg body weight) group were much lower than those in the transplant control group (iNOS: 2.01 ± 0.23 vs 26.59 ± 5.78, P < 0.01 and blood sugar: 14.2 ± 0.9 vs 16.8 ± 1.1, P < 0.01). CONCLUSION:Selective iNOS inhibitor, aminoguanidine as a free radical, has a protective effect on pancreas transplantation in rats by inhibiting NO and reducing its toxicity.

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“…De acordo com esse modelo descrito, a célula acinar, que está presente no pâncreas na forma inativa, seria ativada, tornando-se capaz de liberar uma série de fatores potencialmente lesivos de alcance local e sistêmico, como fator ativador de plaquetas (platelet activating factor -PAF), espécies de oxigênio reativo (reactive oxygen species -ROS), TGF-β, óxido nítrico (NO), TNF-a, IL-6 e quimiocinas (MOLERO et al, 2003;LEINDLER et al, 2004;RAMUDO et al, 2005). As quimiocinas secretadas atraem leucócitos, inicialmente neutrófilos e posteriormente monomorfonucleares (KIMURA et al, 2003).…”

Section: Hipóteses Sobre O Mecanismo Iniciador Da Lesãounclassified

“…A apoptose foi predominantemente encontrada na forma leve da pancreatite, e a necrose na forma grave. A apoptose das células acinares causa menos destruição para o pâncreas que a necrose, e os dois processos podem ser induzidos por neutrófilos (LEINDLER et al, 2004;GUZMAN;RUDNICKI, 2006). Na porção exterior do pâncreas, é encontrada gordura, a qual varia quantitativamente nos diferentes indivíduos.…”

Section: Apoptose E Necrose Pancreáticaunclassified

A pancreatite aguda na visão do imunologista

Bendicho

Guedes

Lyra

et al. 2010

cmbio

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ResumoA pancreatite aguda é um processo inflamatório do pâncreas, decorrente da ação de enzimas inadequadamente ativadas, que causam edema, hemorragia e até necrose pancreática e peripancreática. As células acinares presentes no pâncreas assim como as células estelares pancreáticas tem sido alvo de estudo como participantes na formação do processo inflamatório juntamente com outras células inflamatórias. Diversas citocinas são liberadas durante a pancreatite, e assim, o processo inflamatório inicialmente local, pode ter uma repercussão sistêmica importante, e o paciente poderá apresentar hipovolemia, comprometimento de múltiplos órgãos e sistemas e possibilidade de óbito. A condição clinica da pancreatite na forma leve ou grave dependerá da extensão do processo e das complicações que podem advir. Palavras-chave: Pancreatite aguda -Citocinas -Necrose pancreática. Abstract The acute pancreatitis is an inflammatory process of the pancreas, resulting from the action of enzymes activated inappropriately, causing swelling, bleeding and even pancreatic necrosis and peripancreática. The acinar cells in the pancreas and stellar cells pancreatic has been the study as participants in shaping the inflammatory process along with other inflammatory cells. Several cytokines are released during pancreatitis, and thus, the local inflammatory process initially, may have an important

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Importance of Cytokines, Nitric Oxide, and Apoptosis in the Pathological Process of Necrotizing Pancreatitis in Rats

Cited by 65 publications

References 24 publications

Clinical outcomes in patients with ICU-related pancreatitis

Clinical outcomes in patients with ICU-related pancreatitis

Protective effect of inducible nitric oxide synthase inhibitor on pancreas transplantation in rats

A pancreatite aguda na visão do imunologista

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