Schoenberg M H, Birk D, Beger H G
Department of General Surgery, University of Ulm, Germany.
Am J Clin Nutr. 1995 Dec;62(6 Suppl):1306S-1314S. doi: 10.1093/ajcn/62.6.1306S.
Oxygen radicals mediate an important step in the initiation of acute pancreatitis. These reactive oxygen metabolites are generated at an early stage of the disease. The source of the enhanced production of oxygen radicals, however, still remains unclear. Experimentally, the effectiveness of antioxidant treatment varies from one model to the other, the differences depending on the experimental model and not on the form of pancreatitis that was induced. In most studies, the experimental animals were pretreated before acute pancreatitis was induced. This does not mirror clinical reality because patients are admitted to the hospital after the onset of the disease. It was shown in cerulein-induced pancreatitis, however, that scavenger treatment also mitigated the pancreatic tissue damage after induction of acute pancreatitis. Moreover, antioxidant treatment also attenuated the extrapancreatic complications, thus improving the final outcome of the disease. Initial indirect observations also suggest that in human acute, acute recurrent, and chronic pancreatitis, oxygen free radicals are generated and add to the damage. Concomitantly, these patients suffer from a severe depletion of oxidative stress. Whether or not this disbalance is instrumental in the development and course of disease remains unanswered. Supplementation with antioxidants that are deficient in patients with acute pancreatitis might be a feasible option to the present therapy to avoid extrapancreatic complications. Well-defined, controlled clinical trials involving patients suffering from acute pancreatitis are therefore needed to validate the role of oxygen radicals in this disease.
氧自由基在急性胰腺炎的起始过程中介导一个重要步骤。这些活性氧代谢产物在疾病早期产生。然而，氧自由基产生增加的来源仍不清楚。在实验中，抗氧化治疗的效果因模型而异，差异取决于实验模型而非诱导的胰腺炎类型。在大多数研究中，实验动物在诱导急性胰腺炎之前进行了预处理。这并不反映临床实际情况，因为患者是在疾病发作后才入院的。然而，在雨蛙肽诱导的胰腺炎中发现，清除剂治疗在诱导急性胰腺炎后也减轻了胰腺组织损伤。此外，抗氧化治疗还减轻了胰腺外并发症，从而改善了疾病的最终结局。初步的间接观察还表明，在人类急性、急性复发性和慢性胰腺炎中，氧自由基会产生并加重损伤。与此同时，这些患者存在严重的氧化应激消耗。这种失衡是否在疾病的发生和发展过程中起作用仍未得到解答。补充急性胰腺炎患者缺乏的抗氧化剂可能是目前治疗方法中避免胰腺外并发症的一个可行选择。因此，需要开展针对急性胰腺炎患者的明确、对照的临床试验，以验证氧自由基在这种疾病中的作用。
