Bhatia M, Brady M, Zagorski J, Christmas S E, Campbell F, Neoptolemos J P, Slavin J
Department of Surgery, University of Liverpool, Royal Liverpool University Hospital, Liverpool, UK.
Gut. 2000 Dec;47(6):838-44. doi: 10.1136/gut.47.6.838.
Lung injury manifest clinically as adult respiratory distress syndrome (ARDS) is a common cause of morbidity and mortality following acute pancreatitis (AP). Neutrophils play a critical role in the progression of AP to ARDS. C-x-C chemokines are potent neutrophil chemoattractants and activators and have been implicated in AP.
To evaluate the effect of blocking the C-x-C chemokine, cytokine induced neutrophil chemoattractant (CINC), in AP on pancreatic inflammation and the associated lung injury in rats.
AP was induced by hourly intraperitoneal injections of caerulein. Goat anti-CINC antibody was administered either before or after starting caerulein injections to evaluate the prophylactic and therapeutic effects, respectively. Severity of AP was determined by measuring plasma amylase, pancreatic water content, and pancreatic myeloperoxidase (MPO) activity as a measure of neutrophil sequestration in the pancreas. Lung injury was determined by measurement of pulmonary microvascular permeability and lung MPO activity.
Treatment with anti-CINC antibody had little effect on caerulein induced pancreatic damage. However, it reduced the caerulein mediated increase in lung MPO activity as well as lung microvascular permeability when administered either prophylactically (lung MPO (fold increase over control): 1.53 (0.21) v. 3.30 (0.46), p<0.05; microvascular permeability (L/P%): 0.42 (0.07) v. 0.77 (0.11), p<0.05) or therapeutically (lung MPO (fold increase over control): 2.13 (0.10) v 4.42 (0.65), p<0.05; microvascular permeability (L/P%): 0.31 (0.05) v 0.79 (0.13), p<0.05).
Treatment with anti-CINC antibody afforded significant protection against pancreatitis associated lung injury. These results suggest that CINC plays an important role in the systemic inflammatory response in AP.
临床上表现为成人呼吸窘迫综合征(ARDS)的肺损伤是急性胰腺炎(AP)后发病和死亡的常见原因。中性粒细胞在AP进展为ARDS的过程中起关键作用。C-X-C趋化因子是强效的中性粒细胞趋化剂和激活剂,与AP有关。
评估阻断C-X-C趋化因子细胞因子诱导的中性粒细胞趋化剂(CINC)对大鼠AP胰腺炎症及相关肺损伤的影响。
通过每小时腹腔注射雨蛙素诱导AP。在开始注射雨蛙素之前或之后给予山羊抗CINC抗体,分别评估预防和治疗效果。通过测量血浆淀粉酶、胰腺含水量和胰腺髓过氧化物酶(MPO)活性来确定AP的严重程度,MPO活性作为胰腺中中性粒细胞隔离的指标。通过测量肺微血管通透性和肺MPO活性来确定肺损伤。
抗CINC抗体治疗对雨蛙素诱导的胰腺损伤影响不大。然而,当预防性给药(肺MPO(相对于对照组的增加倍数):1.53(0.21)对3.30(0.46),p<0.05;微血管通透性(L/P%):0.42(0.07)对0.77(0.11),p<0.05)或治疗性给药(肺MPO(相对于对照组的增加倍数):2.13(0.10)对4.42(0.65),p<0.05;微血管通透性(L/P%):0.31(0.05)对0.79(0.13),p<0.05)时,它可降低雨蛙素介导的肺MPO活性增加以及肺微血管通透性。
抗CINC抗体治疗为胰腺炎相关肺损伤提供了显著的保护作用。这些结果表明CINC在AP的全身炎症反应中起重要作用。