Malecki Elise A, Castellanos Karla J, Cabay Robert J, Fantuzzi Giamila
From the Departments of *Medicine, †Kinesiology and Nutrition, and ‡Pathology, University of Illinois at Chicago, Chicago, IL.
Pancreas. 2014 Aug;43(6):903-8. doi: 10.1097/MPA.0000000000000115.
Currently, there is no therapy for severe acute pancreatitis (AP) except for supportive care. The lipase inhibitor orlistat, the peroxisome proliferator-activated receptor γ agonist rosiglitazone, and the chemokine receptor 2 antagonists attenuate the severity of AP in rodents if administered before or at the time of induction of pancreatitis. However, it is unknown whether these treatments are effective if administered therapeutically after induction of pancreatitis.
Male C57BL6 mice with diet-induced obesity received 2 injections of mrIL-12 (150 ng per mouse) and mrIL-18 (750 ng per mouse) intraperitoneally at 24-hour intervals. The mice were injected 2, 24, and 48 hours after the second injection of IL-12 + IL-18 with orlistat (2 mg per mouse), rosiglitazone (0.4 mg per mouse), RS102895 (0.3 mg per mouse), or vehicle (20 μL of DMSO and 80 μL of canola oil) and euthanized after 72 hours.
Orlistat decreased intra-abdominal fat necrosis compared with vehicle (P < 0.05). However, none of the drug treatments produced significant decreases in pancreatic edema, acinar necrosis, or intrapancreatic fat necrosis.
Drugs previously shown to improve the severity of AP when given before or at the time of induction of pancreatitis failed to do so when administered therapeutically in the IL-12 + IL-18 model.
目前,除了支持性治疗外,尚无针对重症急性胰腺炎(AP)的疗法。脂肪酶抑制剂奥利司他、过氧化物酶体增殖物激活受体γ激动剂罗格列酮以及趋化因子受体2拮抗剂,若在胰腺炎诱导前或诱导时给药,可减轻啮齿动物AP的严重程度。然而,尚不清楚这些治疗方法在胰腺炎诱导后进行治疗性给药时是否有效。
饮食诱导肥胖的雄性C57BL6小鼠每隔24小时腹腔注射2次重组小鼠白细胞介素-12(mrIL-12,每只小鼠150 ng)和重组小鼠白细胞介素-18(mrIL-18,每只小鼠750 ng)。在第二次注射IL-12 + IL-18后2、24和48小时,给小鼠注射奥利司他(每只小鼠2 mg)、罗格列酮(每只小鼠0.4 mg)、RS102895(每只小鼠0.3 mg)或赋形剂(20 μL二甲基亚砜和80 μL菜籽油),72小时后实施安乐死。
与赋形剂相比,奥利司他可减少腹腔内脂肪坏死(P < 0.05)。然而,这些药物治疗均未使胰腺水肿、腺泡坏死或胰腺内脂肪坏死显著减轻。
在IL-12 + IL-18模型中,先前显示在胰腺炎诱导前或诱导时给药可改善AP严重程度的药物,在进行治疗性给药时未能达到此效果。