Turkyilmaz Serdar, Usta Arif, Cekic Arif Burak, Alhan Etem, Kural Birgül Vanizor, Ercin Cengiz
Department of General Surgery, Faculty of Medicine, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey.
Department of General Surgery, Faculty of Medicine, Farabi Hospital, Karadeniz Technical University, Trabzon, Turkey.
J Surg Res. 2016 Jun 15;203(2):383-9. doi: 10.1016/j.jss.2016.03.004. Epub 2016 Mar 10.
Inflammatory explosion and oxidative stress are important mechanisms of injury in acute necrotizing pancreatitis (ANP). This study investigated the effects of N-acetylcysteine amid (NACA), a novel cell-permeant antioxidant with anti-inflammatory activity, on experimental ANP in rats.
Fifty-two adult male Sprague-Dawley rats were used, and ANP was induced by cerulein. The animals were divided into four groups which were sham + saline, sham + NACA, ANP + saline, and ANP + NACA. NACA (2.2 mg/kg, i.p) was administered for 6 h, after the induction of ANP. The extent of acinar cell injury, mortality, systemic cardiorespiratory variables, functional capillary density, renal/hepatic functions, and changes in some enzyme markers for pancreas and lung tissues were investigated.
Induction of ANP increased mortality from 0% in the sham group to 43.75% in the ANP + saline group (P < 0.05), and administration of NACA significantly reduced mortality to 12.5% (P < 0.05). Induction of ANP also caused increases in pancreatic necrosis, serum amylase, alanine aminotransferase (ALT), interleukin-6, LDH in bronchoalveolar lavage fluid, serum urea, tissue myeloperoxidase in pancreas and lung tissues and malondialdehyde. There was less pronounced increase in these parameters in NACA treated group. Compared with ANP group, ANP + NACA group had lower levels of pancreatic necrosis (0.5 ± 0.2 versus 1.45 ± 0.2, P < 0.05) and inflammation (0.6 ± 0.2 versus 1.29 ± 00.3, P < 0.05) scores.
Administration of NACA significantly decreased the ANP-induced mortality and also provided significant improvements in hemodynamic changes. The obtained positive effects of NACA on the course of pancreatitis indicates its potential usefulness in the management of ANP.
炎症爆发和氧化应激是急性坏死性胰腺炎(ANP)损伤的重要机制。本研究调查了新型具有抗炎活性的细胞渗透性抗氧化剂N - 乙酰半胱氨酸酰胺(NACA)对大鼠实验性ANP的影响。
使用52只成年雄性Sprague - Dawley大鼠,采用雨蛙素诱导ANP。将动物分为四组,即假手术 + 生理盐水组、假手术 + NACA组、ANP + 生理盐水组和ANP + NACA组。在诱导ANP后,腹腔注射NACA(2.2mg/kg),持续6小时。研究腺泡细胞损伤程度、死亡率、全身心肺变量、功能性毛细血管密度、肾/肝功能以及胰腺和肺组织中一些酶标志物的变化。
ANP诱导使死亡率从假手术组的0%增加到ANP + 生理盐水组的43.75%(P < 0.05),而给予NACA可显著降低死亡率至12.5%(P < 0.05)。ANP诱导还导致胰腺坏死、血清淀粉酶、丙氨酸转氨酶(ALT)、支气管肺泡灌洗液中的白细胞介素 - 6、乳酸脱氢酶、血清尿素、胰腺和肺组织中的组织髓过氧化物酶以及丙二醛增加。在NACA治疗组中,这些参数的增加不太明显。与ANP组相比,ANP + NACA组的胰腺坏死水平(0.5±0.2对1.45±0.2,P < 0.05)和炎症评分(0.6±0.2对1.29±0.3,P < 0.05)较低。
给予NACA可显著降低ANP诱导的死亡率,并在血流动力学变化方面有显著改善。NACA对胰腺炎病程的积极作用表明其在ANP治疗中具有潜在应用价值。