Kusske A M, Rongione A J, Ashley S W, McFadden D W, Reber H A
Department of Surgery, UCLA Medical Center 90024, USA.
Surgery. 1996 Aug;120(2):284-8; discussion 289. doi: 10.1016/s0039-6060(96)80299-6.
Cytokines derived from macrophages may play an integral role in the evolution of acute pancreatitis. Interleukin-10 (IL-10), a potent antiinflammatory cytokine, prevents the activation of macrophages and their release of inflammatory cytokines. The aim of this study was to determine whether treatment with IL-10 decreased the severity of experimental acute pancreatitis.
Thirty female Swiss Webster mice were divided into three groups. Acute pancreatitis was induced by using a choline-deficient, 0.5% ethionine supplemented (CDE) diet. Group A (controls) received CDE diet alone. Group B was pretreated with 10,000 units of intraperitoneal IL-10 at the onset of feeding and every 8 hours thereafter. Group C received IL-10 33 hours after beginning the CDE diet and every 8 hours thereafter. One half of the animals in each group was killed at 54 hours; the remaining living animals were killed at 80 hours. Serum amylase levels (units per liter) were determined at 54 and 80 hours. Pancreata were harvested and fixed in formalin. Histologic characteristics were graded on a scale from 0 to 4 (normal to most abnormal) in a blinded fashion by two investigators.
Serum amylase level and histologic score (edema, inflammation, hemorrhage, and necrosis) were significantly reduced when IL-10 was administered either prophylactically or therapeutically (p < 0.01). At 54 hours all animals were alive. Mortality was reduced at 80 hours in both groups treated with IL-10 compared with those fed the CDE diet alone (p < 0.001).
These results suggested that macrophages play an integral role in determining the severity of acute pancreatitis in this animal model. The finding that IL-10 decreased inflammation and prevented death, even when given after acute pancreatitis was established, suggests that it may have potential for clinical use.
巨噬细胞衍生的细胞因子可能在急性胰腺炎的发展过程中起重要作用。白细胞介素-10(IL-10)是一种强效抗炎细胞因子,可阻止巨噬细胞的激活及其炎性细胞因子的释放。本研究的目的是确定IL-10治疗是否能降低实验性急性胰腺炎的严重程度。
30只雌性瑞士韦伯斯特小鼠分为三组。采用胆碱缺乏、0.5%乙硫氨酸补充(CDE)饮食诱导急性胰腺炎。A组(对照组)仅接受CDE饮食。B组在开始喂食时腹腔注射10000单位IL-10预处理,此后每8小时注射一次。C组在开始CDE饮食33小时后接受IL-10治疗,此后每8小时注射一次。每组一半的动物在54小时处死;其余存活的动物在80小时处死。在54小时和80小时测定血清淀粉酶水平(单位/升)。取出胰腺并固定在福尔马林中。由两名研究人员以盲法对组织学特征进行评分,范围为0至4分(从正常到最异常)。
预防性或治疗性给予IL-10时,血清淀粉酶水平和组织学评分(水肿、炎症、出血和坏死)均显著降低(p<0.01)。54小时时所有动物均存活。与仅喂食CDE饮食的动物相比,IL-10治疗的两组在80小时时死亡率降低(p<0.001)。
这些结果表明巨噬细胞在该动物模型中急性胰腺炎严重程度的决定中起重要作用。即使在急性胰腺炎形成后给予IL-10仍能减轻炎症并预防死亡,这一发现表明其可能具有临床应用潜力。