Grewal H P, Kotb M, el Din A M, Ohman M, Salem A, Gaber L, Gaber A O
Department of Surgery, University of Tennessee School of Medicine, Memphis.
Surgery. 1994 Feb;115(2):213-21.
Tumor necrosis factor (TNF) is rapidly gaining recognition as one of the early, critical mediators of several inflammatory conditions, most notably endotoxic shock. The purposes of this study were to determine whether TNF levels are raised in severe acute pancreatitis, thus pointing to its role as a potential mediator of the inflammatory process, and to determine the possible sites of production and uptake.
TNF levels were measured during a 2-hour period in a rat model of acute pancreatitis by using an antegrade infusion of artificial bile. TNF levels were measured with a bioassay.
TNF levels increased proportionately with time and serum amylase level, reaching a mean value of 2700 pg/ml at 2 hours compared with sham operated rats (mean, 125 pg/ml) (p < 0.001). TNF levels in nonoperated controls were undetectable. These measurements were found to be independent of endotoxin production. In addition, selective sampling from the portal vein, hepatic vein, and femoral artery showed hepatic degradation of TNF (p < 0.005), indicating that the liver may play an important role in protecting the host from multiple organ failure.
Our results showed that TNF levels are elevated in acute pancreatitis and may suggest a role for this cytokine in the pathogenesis of the disease.
肿瘤坏死因子（TNF）正迅速成为多种炎症状态（尤其是内毒素休克）早期关键介质之一而受到认可。本研究的目的是确定严重急性胰腺炎时TNF水平是否升高，从而指明其作为炎症过程潜在介质的作用，并确定其可能的产生和摄取部位。
在大鼠急性胰腺炎模型中，通过顺行输注人工胆汁，在2小时内测量TNF水平。采用生物测定法测量TNF水平。
TNF水平随时间和血清淀粉酶水平成比例增加，与假手术大鼠（平均值为125 pg/ml）相比，2小时时达到平均值2700 pg/ml（p < 0.001）。未手术对照组的TNF水平检测不到。这些测量结果与内毒素产生无关。此外，从门静脉、肝静脉和股动脉进行选择性采样显示肝脏对TNF有降解作用（p < 0.005），表明肝脏可能在保护宿主免受多器官功能衰竭方面发挥重要作用。
我们的结果表明急性胰腺炎时TNF水平升高，这可能提示该细胞因子在疾病发病机制中的作用。
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