Zhang Xi-Ping, Zhang Ling, Chen Lin-Jie, Cheng Qi-Hui, Wang Jian-Mei, Cai Wei, Shen Hai-Ping, Cai Jun
Department of General Surgery, Hangzhou First People's Hospital, 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China.
World J Gastroenterol. 2007 Jan 28;13(4):548-56. doi: 10.3748/wjg.v13.i4.548.
To observe the therapeutic effects of dexamethasone on rats with severe acute pancreatitis (SAP) and investigate the influences of dexamethasone on the inflammatory mediators and NF-kappaB expression in multiple organs of SAP rats as well as the mechanisms involved.
Ninety Sprague-Dawley (SD) rats with SAP were randomly divided into the model group (n = 45) and dexamethasone treatment group (n = 45), and another 45 rats were selected for the sham operation group. All groups were randomly subdivided into the 3 h, 6 h and 12 h groups, each group containing 15 rats. The survival of all groups and pathological changes of multiple organs (liver, kidney and lung) were observed at different time points after the operation. The pathological score of multiple organs was carried out, followed by the determination of amylase, endotoxin and TNF-alpha contents in blood. The tissue microarray was used to detect the expression levels of NF-kappaB p65 protein in multiple organs.
There was no marked difference between the model group and treatment group in the survival rate. The amylase content of the treatment group was significantly lower compared to the model group at 12 h (P < 0.01, 7791.00 vs 9195.00). Moreover, the endotoxin and TNF-alpha levels of the treatment group were significantly lower than that of the model group at 6 h and 12 h (P < 0.01, 0.040 vs 0.055, 0.042 vs 0.059 and P < 0.05, 58.30 vs 77.54, 38.70 vs 67.30, respectively). Regarding the changes in liver NF-kappaB expression, the model group significantly exceeded the sham operation group at 3 h (P < 0.01, 1.00 vs 0.00), and the treatment group significantly exceeded the sham operation group at 12 h (P < 0.01, 1.00 vs 0.00), whereas no marked difference was observed between the model group and treatment group at all time points. The kidney NF-kappaB expression level in the treatment group significantly exceeded the model group (P < 0.05, 2.00 vs 0.00) and the sham operation group (P < 0.01, 2.00 vs 0.00) at 12 h. No NF-kappaB expression in the lung was found in any group.
Dexamethasone can lower the amylase, endotoxin and TNF-alpha levels as well as mortality of SAP rats. NF-kappaB plays an important role in multiple organ injury. Further studies should be conducted to determine whether dexamethasone can ameliorate the pathological changes of multiple organs by reducing the NF-kappaB expression in the liver and kidney. The advantages of tissue microarrays in pancreatitis pathological examination include time- and energy- saving, and are highly efficient and representative. The restriction of tissue microarrays on the representation of tissues to various extents due to small diameter may lead to the deviation of analysis.
观察地塞米松对重症急性胰腺炎(SAP)大鼠的治疗效果,探讨地塞米松对SAP大鼠多器官炎症介质及核因子κB(NF-κB)表达的影响及其作用机制。
将90只SAP Sprague-Dawley(SD)大鼠随机分为模型组(n = 45)和地塞米松治疗组(n = 45),另选45只大鼠作为假手术组。所有组再随机分为3 h、6 h和12 h组,每组15只大鼠。观察术后不同时间点各组大鼠的存活情况及多器官(肝、肾、肺)病理变化。进行多器官病理评分,随后测定血液中淀粉酶、内毒素及肿瘤坏死因子-α(TNF-α)含量。采用组织芯片检测多器官中NF-κB p65蛋白的表达水平。
模型组与治疗组存活率无明显差异。治疗组12 h时淀粉酶含量显著低于模型组(P < 0.01,7791.00对9195.00)。此外,治疗组6 h和12 h时内毒素及TNF-α水平显著低于模型组(P < 0.01,0.040对0.055,0.042对0.059;P < 0.05,58.30对77.54,38.70对67.30)。关于肝脏NF-κB表达变化,模型组3 h时显著高于假手术组(P < 0.01,1.00对0.00),治疗组12 h时显著高于假手术组(P < 0.01,1.00对0.00),而模型组与治疗组各时间点均无明显差异。治疗组12 h时肾脏NF-κB表达水平显著高于模型组(P < 0.05,2.00对0.00)及假手术组(P < 0.01,2.00对0.00)。各组肺组织均未发现NF-κB表达。
地塞米松可降低SAP大鼠淀粉酶、内毒素及TNF-α水平和死亡率。NF-κB在多器官损伤中起重要作用。应进一步研究地塞米松是否可通过降低肝、肾中NF-κB表达来改善多器官病理变化。组织芯片在胰腺炎病理检查中的优点包括省时、省力,高效且具有代表性。组织芯片因直径小对组织不同程度代表性的限制可能导致分析偏差。