Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Dig Dis Sci. 2021 Dec;66(12):4344-4353. doi: 10.1007/s10620-020-06801-6. Epub 2021 Jan 12.
Acute lung injury (ALI) is the most common complication and one of the leading causes of mortality of severe acute pancreatitis (SAP). Nevertheless, no effective therapeutic schemes are presently available.
To investigate the effect and potential mechanism of mesenteric lymph duct ligation (MLDL) on experimental SAP-induced ALI.
Immediately following MLDL, rats were subjected to SAP by retrograde injection of 5% sodium taurocholate into the biliopancreatic duct. At 24 h after modeling, tissues were collected for morphological examination. The levels of TNF-α, IL-6, intercellular adhesion molecule-1 (ICAM1), diamine oxidase (DAO), and D-lactic acid (D-LA) in serum, and the myeloperoxidase (MPO) activity in lung tissues were determined. Moreover, the expressions of high mobility group box 1 (HMGB1), receptor of advanced glycation endproducts (RAGE), and NF-κB p65 at the mRNA and protein levels in lung tissues, and the expressions of HMGB1, RAGE, and TNF-α at the mRNA level in intestinal lymphoid tissues were evaluated.
MLDL significantly attenuated the histological injury of the pancreas and lung and reduced the production of TNF-α, IL-6, and ICAM1. Besides, MLDL repressed the activity of MPO in the lung. However, the levels of serum DAO and D-LA were decreased without obvious morphological improvement in intestinal injury. Moreover, MLDL apparently reduced the up-regulation of HMGB1, RAGE, and NF-κB p65 in lung tissues, as well as the expressions of HMGB1, RAGE, and TNF-α in intestinal lymphoid tissues.
Mesenteric lymph was a source of harmful factors leading to SAP-ALI. MLDL could alleviate SAP-ALI probably by inhibiting HMGB1-induced production of inflammation factors.
急性肺损伤(ALI)是重症急性胰腺炎(SAP)最常见的并发症之一,也是导致 SAP 患者死亡的主要原因之一。然而,目前尚无有效的治疗方案。
探讨结扎肠系膜淋巴管(MLDL)对实验性 SAP 诱导的 ALI 的影响及其潜在机制。
在 MLDL 后,通过逆行向胆胰管内注射 5%牛磺胆酸钠制备 SAP 模型。建模 24 h 后收集组织进行形态学检查。检测血清中 TNF-α、IL-6、细胞间黏附分子-1(ICAM1)、二胺氧化酶(DAO)和 D-乳酸(D-LA)的水平,以及肺组织髓过氧化物酶(MPO)的活性。此外,还评估了肺组织中高迁移率族蛋白 B1(HMGB1)、晚期糖基化终产物受体(RAGE)和 NF-κB p65 的 mRNA 和蛋白表达水平,以及肠淋巴组织中 HMGB1、RAGE 和 TNF-α 的 mRNA 表达水平。
MLDL 可显著减轻胰腺和肺的组织学损伤,减少 TNF-α、IL-6 和 ICAM1 的产生。此外,MLDL 还抑制了肺组织中 MPO 的活性。然而,血清 DAO 和 D-LA 的水平降低,而肠损伤的形态学改善不明显。此外,MLDL 明显降低了肺组织中 HMGB1、RAGE 和 NF-κB p65 的上调,以及肠淋巴组织中 HMGB1、RAGE 和 TNF-α 的表达。
肠系膜淋巴是导致 SAP-ALI 的有害因素的来源。MLDL 可能通过抑制 HMGB1 诱导的炎症因子产生来减轻 SAP-ALI。