Lüthen R E, Niederau C, Grendell J H
Gastroenterology Section, Veterans Affairs Medical Center, San Francisco, California 94121.
Dig Dis Sci. 1994 Apr;39(4):871-9. doi: 10.1007/BF02087436.
In order to reproduce what might occur during the initial phase in some cases of acute alcohol-induced pancreatitis, rabbits were infused with diluted ethanol and low-dose cerulein. The duct permeability was assessed by recovery of fluoresceinated dextran (molecular weight 19,500) in central venous blood following orthograde duct perfusion with this substance in the anesthetized animal. Serum ethanol, lipase, and amylase were measured; pancreatic duct morphology was examined by light microscopy and electron microscopy. ATP and glutathione were measured, as were amylase, trypsinogen/trypsin, cathepsin B, and DNA levels in differential centrifugates. As expected, acinar amylase and trypsinogen showed a significant decrease in the experimental group; cathepsin B activity was similarly diminished. Compared with the control group, the activity of serum amylase and lipase in the experimental group demonstrated a significant increase. However, no differences between saline-infused control animals and the treated group regarding pancreatic duct permeability, continuity of lumen-lining epithelium, ATP and glutathione levels, and the relative subcellular distribution of pancreatic digestive and lysosomal enzymes were observed. Thus, our findings do not support the relevance of some of the most common hypotheses on the pathophysiology of acute pancreatitis in its early stage for at least a certain subgroup of patients with acute alcohol-induced pancreatitis.
为了重现某些急性酒精性胰腺炎病例初始阶段可能发生的情况,给兔子输注稀释乙醇和低剂量的雨蛙肽。在麻醉动物中,用荧光葡聚糖(分子量19,500)经顺行性胰管灌注后,通过测定中心静脉血中荧光葡聚糖的回收情况来评估胰管通透性。检测血清乙醇、脂肪酶和淀粉酶水平;通过光学显微镜和电子显微镜检查胰管形态。测定ATP和谷胱甘肽水平,以及差速离心物中的淀粉酶、胰蛋白酶原/胰蛋白酶、组织蛋白酶B和DNA水平。正如预期的那样,实验组腺泡淀粉酶和胰蛋白酶原显著降低;组织蛋白酶B活性也同样降低。与对照组相比,实验组血清淀粉酶和脂肪酶活性显著升高。然而,在胰管通透性、管腔衬里上皮的连续性、ATP和谷胱甘肽水平以及胰腺消化酶和溶酶体酶的相对亚细胞分布方面,生理盐水灌注的对照动物与治疗组之间未观察到差异。因此,我们的研究结果不支持关于急性胰腺炎早期病理生理学的一些最常见假设对至少某一亚组急性酒精性胰腺炎患者的相关性。