Mithöfer K, Fernández-del Castillo C, Rattner D, Warshaw A L
Surgical Laboratories, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
Am J Physiol. 1998 Jan;274(1):G71-9. doi: 10.1152/ajpgi.1998.274.1.G71.
To investigate the debated role of intracellular trypsinogen activation and its relation to lysosomal enzyme redistribution in the pathogenesis of acute pancreatitis, rats were infused with the cholecystokinin analog caerulein at 5 micrograms.kg-1.h-1 for intervals up to 3 h, and the changes were contrasted with those in animals receiving saline or 0.25 microgram.kg-1.h-1 caerulein. Saline or 0.25 microgram.kg-1.h-1 caerulein did not induce significant changes. In contrast, 5 micrograms.kg-1.h-1 caerulein caused significant hyperamylasemia and pancreatic edema within 30 min. Pancreatic content of trypsinogen activation peptide (TAP) increased continuously (significant within 15 min). TAP generation was predominantly located in the zymogen fraction during the first hour but expanded to other intracellular compartments thereafter. Cathepsin B activity in the zymogen compartment increased continuously throughout the experiments and correlated significantly with TAP generation in the same compartment. Total trypsinogen content increased to 143% with marked interstitial trypsinogen accumulation after 3 h. Supramaximal caerulein stimulation causes trypsinogen activation by 15 min that originates in the zymogen compartment and is associated with increasing cathepsin B activity in this subcellular compartment. However, a much larger pool of trypsinogen survives and accumulates in the extracellular space and may become critical in the evolution of necrotizing pancreatitis.
为了研究细胞内胰蛋白酶原激活在急性胰腺炎发病机制中存在争议的作用及其与溶酶体酶重新分布的关系,以5微克·千克⁻¹·小时⁻¹的剂量给大鼠输注胆囊收缩素类似物雨蛙肽,持续3小时,将这些变化与接受生理盐水或0.25微克·千克⁻¹·小时⁻¹雨蛙肽的动物的变化进行对比。生理盐水或0.25微克·千克⁻¹·小时⁻¹雨蛙肽未引起显著变化。相比之下,5微克·千克⁻¹·小时⁻¹雨蛙肽在30分钟内导致显著的高淀粉酶血症和胰腺水肿。胰蛋白酶原激活肽(TAP)的胰腺含量持续增加(15分钟内显著)。TAP的产生在最初1小时主要位于酶原部分,但此后扩展到其他细胞内区室。在整个实验过程中,酶原区室中的组织蛋白酶B活性持续增加,并且与同一区室中TAP的产生显著相关。3小时后,总胰蛋白酶原含量增加到143%,伴有明显的间质胰蛋白酶原积聚。超最大剂量的雨蛙肽刺激在15分钟内导致胰蛋白酶原激活,其起源于酶原区室,并与该亚细胞区室中组织蛋白酶B活性增加有关。然而,大量的胰蛋白酶原存活并积聚在细胞外空间,这可能在坏死性胰腺炎的发展中起关键作用。