The role of the gut in the development of sepsis in acute pancreatitis

Runkel, N.; Moody, Frank G.; Smith, Gregory S.; Rodriguez, Liliana F.; LaRocco, Mark; Miller, Thomas A.

doi:10.1016/0022-4804(91)90064-s

Cited by 201 publications

(118 citation statements)

References 25 publications

Supporting

Mentioning

106

Contrasting

Unclassified

Order By: Relevance

“…In the 1990s, several authors observed a positive correlation between bacterial translocation and IAP in animal models, even when IAP was raised for less than 1 h. This result was caused by increased gut permeability induced by splanchnic ischemia with and without reperfusion [27,28] . The mechanism by which the necrotic pancreas becomes infected is unclear, but experimental and clinical data suggest that the gastrointestinal tract is the likely source of organisms, since intestinal colonization by pathogens often precedes pancreatic infection [29][30][31][32][33] . The gut clearly plays a major role in the development of MODS.…”

Section: Discussionmentioning

confidence: 99%

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

Chen¹,

Li²,

Sun³

et al. 2008

WJG

122

123

View full text Add to dashboard Cite

AIM:To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of IAH/ACS and outcome. METHODS: Patients (n = 74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n = 44) with IAP ≥ 12 mmHg were assigned in IAH group, and the remaining patients (n = 30) with IAP < 12 mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality. RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 ± 3.90 vs 15.70 ± 4.25, P = 0.616; 3.70 ± 0.93 vs 3.47 ± 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period of the first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r = 0.635, P < 0.001). Although ACS patients had obvious amelioration in physiological variables within 24 h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P < 0.001; septic shock: 70.0% vs 11.1%, P < 0.001; MODS: 90.0% vs 31.5%, P < 0.001; mortality: 75.0% vs 3.7%, P < 0.001). CONCLUSION: IAH/ACS is

show abstract

Section: Discussionmentioning

confidence: 99%

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

Chen¹,

Li²,

Sun³

et al. 2008

WJG

122

123

View full text Add to dashboard Cite

show abstract

“…The following progression of AP is associated with infiltration of various inflammatory cells that produce many cytokines and ROS (13). Moreover, severe AP is often accompanied by bacterial translocation from the digestive tract, resulting in systemic inflammatory response syndrome with multiple organ dysfunction (35). Thus endotoxin, a LPS present in the gram-negative bacterial wall, is thought to be strongly involved in the progression of AP leading to severe disease (14).…”

Section: Discussionmentioning

confidence: 99%

Protective roles of redox-active protein thioredoxin-1 for severe acute pancreatitis

Ohashi¹,

Nishio²,

Nakamura³

et al. 2006

American Journal of Physiology-Gastrointestinal and Liver Physi

View full text Add to dashboard Cite

show abstract

“…In the cases of sepsis, it has been proven that macrophages produce anandamide and participate in shock by LPS stimulation (Varga et al 1998). In severe acute pancreatitis it bacteremia occurs by bacterial translocation (Runkel et al 1991). However it is rare that complication of bacteremia is observed by 6 hours after the induc- (n = 4).…”

Section: Discussionmentioning

confidence: 99%

The Cannabinoid 1 Receptor Antagonist, AM251, Prolongs the Survival of Rats with Severe Acute Pancreatitis

Matsuda

Mikami

Takeda

et al. 2005

Tohoku J. Exp. Med.

View full text Add to dashboard Cite

It has recently been recognized that anandamide (arachidonylethanolamide), which is an endogeneous-cannabinoid (endocannabinoid), mediates septic shock. Cannabinoid means a mind-active material in cannabis (marijuana). Anandamide is mainly produced by macrophages. Cannabinoid 1 (CB1) receptor, which is one of the cannabiniod receptors, is also known to mediate hypotensive shock. The role of endocannabinoids in the progression of acute pancreatitis is unclear. The aims of this study are to clarify their relationship and to find a new therapeutic strategy by regulating the endocannabinoid signaling in acute pancreatitis. Male Wistar rats were injected with caerulein intravenously to induce mild edematous pancreatitis or injected with 5% sodium taurocholate to the bilio-pancreatic duct to induce severe necrotizing pancreatitis. The animals in the latter group were also injected with a CB1 receptor antagonist, AM251, or vehicle solution to see if the inhibition of endocannabinoids improves their survival. Plasma anandamide level was measured by the liquid chromatography/tandem mass spectrometry method. In both models of acute pancreatitis, the plasma anandamide levels were increased, and the levels were significantly higher in rats with severe necrotizing pancreatitis than those in rats with mild edematous pancreatitis. The mean arterial pressure and survival rate were significantly improved by the treatment with AM251, despite that the local inflammatory changes in the pancreas and various parameters (white blood cells, hematocrit, serum amylase, and serum interleukin-6) were similar. This is the first report to show that endocannabinoids are involved in the deterioration of acute pancreatitis and that the down-regulation of endocannabinoid signaling may be a new therapeutic strategy for severe acute pancreatitis.severe acute pancreatitis; septic shock; anandamide; endocannabinoids; AM251

show abstract

The role of the gut in the development of sepsis in acute pancreatitis

Cited by 201 publications

References 25 publications

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

Abdominal compartment syndrome in patients with severe acute pancreatitis in early stage

Protective roles of redox-active protein thioredoxin-1 for severe acute pancreatitis

The Cannabinoid 1 Receptor Antagonist, AM251, Prolongs the Survival of Rats with Severe Acute Pancreatitis

Contact Info

Product

Resources

About