Kuroda T, Shiohara E, Homma T, Furukawa Y, Chiba S
Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Gastroenterology. 1994 Oct;107(4):1125-34. doi: 10.1016/0016-5085(94)90238-0.
BACKGROUND/AIMS: Ischemia-reperfusion injury has been studied in various organs. Effects of leukocyte and platelet depletion on ischemia-reperfusion injury were evaluated using the isolated, perfused dog pancreas in vivo.
Pancreatic exocrine and endocrine functions were stimulated by an intra-arterial injection of cholecystokinin (10(-12) mol) and intravenous injection of glucose and arginine (1 g/kg body wt), respectively. The functions before and after 60 minutes of ischemia were evaluated in the no treatment and in the leukocyte and platelet depletion groups.
Cholecystokinin increased prostaglandin I2 and thromboxane A2 production and stimulated exocrine pancreatic secretion. Glucose and arginine stimulated insulin and glucagon release from the pancreas. Sixty minutes of ischemia followed by 60 minutes of reperfusion damaged the pancreatic acinar and ductular cells. Ischemia of 60 minutes followed by 90 minutes of reperfusion damaged beta cells. Removal of leukocytes (97.6%) and platelets (99.4%) by using a filter throughout the experiment prevented the ischemia-reperfusion injury, reduced plasma lipid peroxide and thromboxane A2, and increased prostaglandin I2 levels.
Leukocytes and platelets seem to damage the pancreas during ischemia-reperfusion by increasing the peroxidation of structurally important cell membrane lipids and reduced the thromboxane A2 prostaglandin I2 ratio, a predictor of cellular injury.
背景/目的：缺血再灌注损伤已在多种器官中得到研究。本研究使用体内分离灌注的犬胰腺评估白细胞和血小板减少对缺血再灌注损伤的影响。
分别通过动脉内注射胆囊收缩素（10⁻¹²摩尔）和静脉注射葡萄糖及精氨酸（1克/千克体重）刺激胰腺外分泌和内分泌功能。在未治疗组以及白细胞和血小板减少组中评估缺血60分钟前后的功能。
胆囊收缩素增加前列腺素I2和血栓素A2的生成，并刺激胰腺外分泌。葡萄糖和精氨酸刺激胰腺释放胰岛素和胰高血糖素。缺血60分钟后再灌注60分钟会损伤胰腺腺泡和导管细胞。缺血60分钟后再灌注90分钟会损伤β细胞。在整个实验过程中使用过滤器去除白细胞（97.6%）和血小板（99.4%）可预防缺血再灌注损伤，降低血浆脂质过氧化物和血栓素A2水平，并提高前列腺素I2水平。
白细胞和血小板似乎在缺血再灌注期间通过增加结构重要的细胞膜脂质过氧化作用以及降低血栓素A2与前列腺素I2的比值（细胞损伤的预测指标）来损伤胰腺。
