Hughes C B, Henry J, Kotb M, Lobaschevsky A, Sabek O, Gaber A O
Department of Surgery, University of Tennessee, College of Medicine, Memphis 38163, USA.
J Surg Res. 1995 Dec;59(6):687-93. doi: 10.1006/jsre.1995.1224.
Tumor necrosis factor-alpha (TNF alpha) is postulated to be a mediator of the systemic complications associated with acute pancreatitis. Neutralization of TNF alpha with monoclonal antibody ameliorates the morbidity and mortality associated with acute pancreatitis in a rat model. Although high levels of TNF alpha are measurable in peripheral blood in acute pancreatitis, specific sites of TNF alpha production in this disease have not been described. In this study we show that induction of pancreatitis causes up-regulation of TNF alpha messenger RNA (mRNA) at a distant organ site, the spleen. Hemisplenectomies were performed in male Sprague-Dawley rats prior to induction of pancreatitis by pancreatic duct infusion of artificial bile. Completion hemisplenectomies were then performed at 30 min, 1 hr, and 2 hr after pancreatitis induction. Quantitation of TNF alpha mRNA in the hemispleens before and after pancreatitis using a semiquantitative reverse transcriptase-polymerase chain reaction method revealed an 80-fold increase in amount of TNF alpha mRNA by 2 hr after induction of pancreatitis. By contrast, control rats receiving a sham operation showed no significant increase in TNF alpha mRNA expression after infusion of the pancreatic duct with saline. The increase in TNF alpha mRNA production was associated with increased serum TNF alpha product levels and was independent of endotoxin. We conclude that severe acute pancreatitis in the rat model is associated with significant up-regulation of TNF alpha mRNA in splenic mononuclear cells. These data provide evidence that the local events of acute pancreatitis can induce up-regulation of TNF alpha mRNA at a distant site and suggest a possible mechanism of pathogenesis of the systemic manifestations of this disease.
肿瘤坏死因子-α(TNF-α)被认为是与急性胰腺炎相关的全身并发症的介质。用单克隆抗体中和TNF-α可改善大鼠模型中与急性胰腺炎相关的发病率和死亡率。尽管在急性胰腺炎患者的外周血中可检测到高水平的TNF-α,但尚未描述该疾病中TNF-α的具体产生部位。在本研究中,我们发现胰腺炎的诱导会导致远处器官脾脏中TNF-α信使核糖核酸(mRNA)的上调。在通过胰管注入人工胆汁诱导雄性Sprague-Dawley大鼠发生胰腺炎之前,先进行半脾切除术。然后在诱导胰腺炎后30分钟、1小时和2小时进行完全半脾切除术。使用半定量逆转录聚合酶链反应方法对胰腺炎前后半脾中的TNF-α mRNA进行定量分析,结果显示胰腺炎诱导后2小时,TNF-α mRNA的量增加了80倍。相比之下,接受假手术的对照大鼠在胰管注入生理盐水后,TNF-α mRNA表达没有显著增加。TNF-α mRNA产生的增加与血清TNF-α产物水平的增加相关,且与内毒素无关。我们得出结论,大鼠模型中的重症急性胰腺炎与脾单核细胞中TNF-α mRNA的显著上调有关。这些数据表明,急性胰腺炎的局部事件可诱导远处部位TNF-α mRNA的上调,并提示了该疾病全身表现发病机制的一种可能机制。