Jo Yun Ju, Choi Ho Soon, Jun Dae Won, Lee Oh Young, Kang Joo Seop, Park Il Gyu, Jung Kyung Hwan, Hahm Joon Soo
Department of Internal Medicine, Eulji University College of Medicine, 280-1 Hagye 1-Dong, Nowon-Gu, Seoul 139-711, South Korea.
Int Immunopharmacol. 2008 Jul;8(7):959-66. doi: 10.1016/j.intimp.2008.02.014. Epub 2008 Mar 27.
Pancreatic and neutrophil elastase can aggravate or induce acute pancreatitis. Although increased elastase levels in the plasma of pancreatitis patients and animal models have been reported, the mechanism by which elastase is involved in the pathogenesis of acute pancreatitis has not yet been elucidated. We aimed to investigate the effects and the possible mechanism of a new human leukocyte elastase inhibitor (recombinant guamerin) in the treatment of cerulein-induced acute pancreatitis in rats.
Fifty Sprague-Dawley rats were divided into three groups: a saline-infused control group (I), a cerulein-induced acute pancreatitis group (II), and a cerulein plus guamerin infusion group (III). Guamerin (1-2 micromol/kg/h) was infused continuously in group III. The severity of pancreatitis was determined biochemically, histologically, and by cytokine changes between groups I, II and III.
Significant differences in serum amylase, lipase, and pancreatic wet weight were observed in each group, respectively (group I; 2346.2 IU/L, 9.9 IU/L, 1.4+/-0.3 g, group II; 13,596.8 IU/L, 7439.4 IU/L, 2.2+/-0.5 g, group III; 9443.2 IU/L, 4516.3 IU/L, 1.7+/-0.6 g). Serum IL-6 and TNF-alpha [AU1]level peaked 1-4 h and 1-2 h. After the induction of pancreatitis, IL-6 and TNF-alpha levels were decreased in group III than group II, (group I; 13.1/4.0 pg/mL, group II; 198.5/63.2 pg/mL, group III; 102.1/13.1 pg/mL), but no significant difference in IL-1beta was observed. Histologic gradings and severity, such as vacuolization, inflammation, lobular disarray, and edema of the pancreas, were significantly lower in the cerulein plus guamerin infusion group III.
Recombinant guamerin, a new human leukocyte elastase inhibitor, may decrease the severity of pancreatitis and diminish pancreatic acinar cell injury by inhibition of neutrophilic infiltration and cytokine activation in the initial stage of cerulein-induced acute pancreatitis in rats.
胰腺弹性蛋白酶和中性粒细胞弹性蛋白酶可加重或诱发急性胰腺炎。尽管已有报道称胰腺炎患者和动物模型血浆中的弹性蛋白酶水平升高,但弹性蛋白酶参与急性胰腺炎发病机制的具体机制尚未阐明。我们旨在研究一种新型人白细胞弹性蛋白酶抑制剂(重组瓜美林)对雨蛙肽诱导的大鼠急性胰腺炎的治疗作用及可能机制。
将50只Sprague-Dawley大鼠分为三组:生理盐水输注对照组(I组)、雨蛙肽诱导的急性胰腺炎组(II组)和雨蛙肽加瓜美林输注组(III组)。III组持续输注瓜美林(1 - 2微摩尔/千克/小时)。通过生化、组织学及I、II、III组间细胞因子变化来确定胰腺炎的严重程度。
每组血清淀粉酶、脂肪酶及胰腺湿重均存在显著差异(I组:2346.2国际单位/升、9.9国际单位/升、1.4±0.3克;II组:13596.8国际单位/升、7439.4国际单位/升、2.2±0.5克;III组:9443.2国际单位/升、4516.3国际单位/升、1.7±0.6克)。血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平分别在1 - 4小时和1 - 2小时达到峰值。胰腺炎诱导后,III组的IL-6和TNF-α水平低于II组(I组:13.1/4.0皮克/毫升,II组:198.5/63.2皮克/毫升,III组:102.1/13.1皮克/毫升),但IL-1β未观察到显著差异。在雨蛙肽加瓜美林输注的III组中,胰腺的组织学分级及严重程度,如空泡化、炎症、小叶紊乱和水肿等均显著降低。
新型人白细胞弹性蛋白酶抑制剂重组瓜美林可能通过抑制大鼠雨蛙肽诱导的急性胰腺炎初始阶段的中性粒细胞浸润和细胞因子激活,减轻胰腺炎的严重程度并减少胰腺腺泡细胞损伤。