Abe R, Shimosegawa T, Kimura K, Abe T, Kashimura J, Koizumi M, Toyota T
Third Department of Internal Medicine, Tohoku University School of Medicine, Miyagi, Japan.
Gastroenterology. 1995 Sep;109(3):933-43. doi: 10.1016/0016-5085(95)90404-2.
BACKGROUND & AIMS: Cytokines activate the hypothalamic-pituitary-adrenal axis and suppress inflammation by stimulating glucocorticoid secretion. The state of adrenocortical function during acute pancreatitis and its role in this disease were determined.
Cerulein-induced pancreatitis or closed duodenal loop pancreatitis was produced in rats that had undergone adrenalectomy or sham adrenalectomy, and the serum corticosterone and interleukin 8 levels and the intensity of the pancreatitis were examined.
Serum corticosterone levels were significantly higher than basal levels in both models of experimental pancreatitis. In both models, adrenalectomy increased serum amylase and pancreatic edema and produced more severe inflammation. Adrenalectomy significantly increased mortality in animals with closed duodenal loop pancreatitis. Exogenous hydrocortisone administered to adrenalectomized animals suppressed the elevation of serum interleukin 8 levels and decreased both the severity of pancreatitis and mortality.
These results suggest that the adrenocortical function is stimulated during acute pancreatitis and that the secretion of endogenous glucocorticoids may play an important role in mitigating the progress of this disease, probably by inhibiting cytokine production.
细胞因子通过刺激糖皮质激素分泌来激活下丘脑 - 垂体 - 肾上腺轴并抑制炎症。我们确定了急性胰腺炎期间肾上腺皮质功能的状态及其在该疾病中的作用。
在接受肾上腺切除术或假肾上腺切除术的大鼠中诱发雨蛙肽诱导的胰腺炎或闭合十二指肠襻性胰腺炎，并检测血清皮质酮、白细胞介素8水平以及胰腺炎的严重程度。
在两种实验性胰腺炎模型中，血清皮质酮水平均显著高于基础水平。在两种模型中，肾上腺切除术均增加了血清淀粉酶和胰腺水肿，并导致更严重的炎症。肾上腺切除术显著增加了闭合十二指肠襻性胰腺炎动物的死亡率。给肾上腺切除的动物注射外源性氢化可的松可抑制血清白细胞介素8水平的升高，并降低胰腺炎的严重程度和死亡率。
这些结果表明，急性胰腺炎期间肾上腺皮质功能受到刺激，内源性糖皮质激素的分泌可能通过抑制细胞因子产生，在减轻该疾病的进展中发挥重要作用。
