Hughes C B, Gaber L W, Mohey el-Din A B, Grewal H P, Kotb M, Mann L, Gaber A O
Department of Surgery, University of Tennessee, College of Medicine, Memphis 38163, USA.
Am Surg. 1996 Jan;62(1):8-13.
The development of systemic complications in acute pancreatitis is largely responsible for the mortality associated with this disease. The systemic sequelae encountered in acute pancreatitis are similar to those occurring in patients with septic shock, a syndrome of multiple organ failure thought to be related to overproduction of inflammatory cytokines. As with sepsis, data is mounting that cytokines, particularly TNF alpha, may play a central role in acute pancreatitis and mediate the systemic sequelae of the disease. We have previously shown elevated levels of TNF alpha in the serum of animals with experimental acute pancreatitis. In this study, we use a bile-infusion model of pancreatitis in the rat to show amelioration of disease severity as well as a distinct survival advantage by TNF alpha blockade using anti-TNF alpha polyclonal antibody. These data provide strong evidence that TNF alpha is a major contributor to the morbidity and mortality from acute pancreatitis.
急性胰腺炎全身并发症的发生在很大程度上决定了该疾病的死亡率。急性胰腺炎中出现的全身后遗症与感染性休克患者的后遗症相似,感染性休克是一种多器官功能衰竭综合征,被认为与炎症细胞因子的过度产生有关。与脓毒症一样,越来越多的数据表明,细胞因子,尤其是肿瘤坏死因子α(TNFα),可能在急性胰腺炎中起核心作用,并介导该疾病的全身后遗症。我们之前已经表明,实验性急性胰腺炎动物血清中的TNFα水平升高。在本研究中,我们使用大鼠胆汁输注胰腺炎模型,通过使用抗TNFα多克隆抗体阻断TNFα来显示疾病严重程度的改善以及明显的生存优势。这些数据提供了强有力的证据,表明TNFα是急性胰腺炎发病和死亡的主要促成因素。