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XU X, SONG Y, JIANG M, LIU M, ZHANG X, WANG D, PAN Y, REN S, LIU X. An assessment of the potential of defatted walnut powder extract against hyperlipidemia-intensified L-arginine-induced acute pancreatitis. FOOD SCIENCE AND TECHNOLOGY 2022. [DOI: 10.1590/fst.19722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Xiajing XU
- Shenyang Pharmaceutical University, China
| | | | - Man JIANG
- Shenyang Pharmaceutical University, China
| | - Meihan LIU
- Shenyang Pharmaceutical University, China
| | | | | | - Yingni PAN
- Shenyang Pharmaceutical University, China
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Jansson L, Carlsson PO. Pancreatic Blood Flow with Special Emphasis on Blood Perfusion of the Islets of Langerhans. Compr Physiol 2019; 9:799-837. [PMID: 30892693 DOI: 10.1002/cphy.c160050] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The pancreatic islets are more richly vascularized than the exocrine pancreas, and possess a 5- to 10-fold higher basal and stimulated blood flow, which is separately regulated. This is reflected in the vascular anatomy of the pancreas where islets have separate arterioles. There is also an insulo-acinar portal system, where numerous venules connect each islet to the acinar capillaries. Both islets and acini possess strong metabolic regulation of their blood perfusion. Of particular importance, especially in the islets, is adenosine and ATP/ADP. Basal and stimulated blood flow is modified by local endothelial mediators, the nervous system as well as gastrointestinal hormones. Normally the responses to the nervous system, especially the parasympathetic and sympathetic nerves, are fairly similar in endocrine and exocrine parts. The islets seem to be more sensitive to the effects of endothelial mediators, especially nitric oxide, which is a permissive factor to maintain the high basal islet blood flow. The gastrointestinal hormones with pancreatic effects mainly influence the exocrine pancreatic blood flow, whereas islets are less affected. A notable exception is incretin hormones and adipokines, which preferentially affect islet vasculature. Islet hormones can influence both exocrine and endocrine blood vessels, and these complex effects are discussed. Secondary changes in pancreatic and islet blood flow occur during several conditions. To what extent changes in blood perfusion may affect the pathogenesis of pancreatic diseases is discussed. Both type 2 diabetes mellitus and acute pancreatitis are conditions where we think there is evidence that blood flow may contribute to disease manifestations. © 2019 American Physiological Society. Compr Physiol 9:799-837, 2019.
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Affiliation(s)
- Leif Jansson
- Uppsala University, Department of Medical Cell Biology, Uppsala, Sweden
| | - Per-Ola Carlsson
- Uppsala University, Department of Medical Cell Biology, Uppsala, Sweden.,Uppsala University, Department of Medical Sciences, Uppsala, Sweden
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Le Campion ER, Jukemura J, Coelho AM, Patzina R, Carneiro D'Albuquerque LA. Effects of intravenous administration of pentoxifylline in pancreatic ischaemia-reperfusion injury. HPB (Oxford) 2013; 15:588-94. [PMID: 23458290 PMCID: PMC3731579 DOI: 10.1111/hpb.12013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Accepted: 10/17/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND Therapeutic strategies to reduce the occurrence of pancreatic ischaemia-reperfusion (I-R) injury might improve outcomes in human pancreas and kidney transplantation. In addition to its haemorrheologic effects, pentoxifylline has an anti-inflammatory effect by inhibiting NF-κB activation. This group has previously demonstrated that pentoxifylline induces an anti-inflammatory response in acute pancreatitis and liver I-R models. This led to the hypothesis that pentoxifylline might reduce pancreatic and renal lesions and the systemic inflammatory response in pancreatic I-R injury. The aim of this experimental study was to evaluate the effect of pentoxifylline administration in a rat model of pancreatic I-R injury. METHODS Pancreatic I-R was performed in Wistar rats over 1 h by clamping the splenic vessels. The animals submitted to I-R were divided into two groups: Group 1 (n = 20, control) rats received saline solution administered i.v. at 45 min after ischaemia, and Group 2 (n = 20) rats received pentoxifylline (25 mg/kg) administered i.v. at 45 min after ischaemia. Blood samples were collected to enable the determination of amylase, creatinine, tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6) and IL-10. Pancreatic malondialdehyde (MDA) content, pancreas histology and pulmonary myeloperoxidase (MPO) were also assessed. RESULTS Significant reductions in serum TNF-α, IL-6 and IL-10 were observed in Group 2 compared with Group 1 (P < 0.05). No differences in pancreatic MDA content or serum amylase levels were observed between the two groups. The histologic score was significantly lower in pentoxifylline-treated animals, denoting less severe pancreatic histologic damage. CONCLUSIONS Pentoxifylline administration reduced the systemic inflammatory response, the pancreatic histological lesion and renal dysfunction in pancreatic I-R injury and may be a useful tool in pancreas and kidney transplantation.
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Affiliation(s)
- Edmond Raymond Le Campion
- Division of Digestive Tract Transplantation (LIM/37), Department of Gastroenterology, University of São Paulo, São Paulo, Brazil.
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Maglione M, Cardini B, Oberhuber R, Watschinger K, Jenny M, Gostner J, Hermann M, Obrist P, Margreiter R, Pratschke J, Brandacher G, Werner ER. Prevention of lethal murine pancreas ischemia reperfusion injury is specific for tetrahydrobiopterin. Transpl Int 2012; 25:1084-95. [PMID: 22805419 PMCID: PMC3499685 DOI: 10.1111/j.1432-2277.2012.01530.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 03/23/2012] [Accepted: 06/18/2012] [Indexed: 12/17/2022]
Abstract
Tetrahydrobiopterin has been shown to efficiently abrogate ischemia reperfusion injury (IRI). However, it is unclear, whether its beneficial action relies on cofactor activity of one of the five known tetrahydrobiopterin-dependent reactions or on its antioxidative capacity. We therefore compared tetrahydrobiopterin with the pterin derivate tetrahydroneopterin (similar biochemical properties, but no nitric oxide synthase cofactor activity) and the antioxidants vitamin C and 5-methyltetrahydrofolate. Donor mice were pretreated with tetrahydrobiopterin, tetrahydroneopterin, vitamin C, or 5-methyltetrahydrofolate. Pancreatic grafts were subjected to 16-h cold ischemia time and implanted in syngeneic recipients. Untreated and nontransplanted animals served as controls. Following 2-h reperfusion, microcirculation was analyzed by intravital fluorescence microscopy. Graft damage was assessed by histology and nitrotyrosine immunostaining, and tetrahydrobiopterin levels were determined by HPLC. Recipient survival served as ultimate readout. Prolonged cold ischemia time resulted in microcirculatory breakdown. Only tetrahydrobiopterin pretreatment succeeded to preserve the capillary net, whereas all other compounds showed no beneficial effects. Along with increased intragraft tetrahydrobiopterin levels during recovery and implantation, only tetrahydrobiopterin pretreatment led to significant reduction of IRI-related parenchymal damage enabling recipient survival. These results show a striking superiority of tetrahydrobiopterin in preventing lethal IRI compared with related compounds and suggest nitric oxide synthases as treatment target.
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Affiliation(s)
- Manuel Maglione
- Center of Operative Medicine, Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Innsbruck, Austria.
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García-Gil FA, Albendea CD, López-Pingarrón L, Royo-Dachary P, Martínez-Guillén J, Piedrafita E, Martínez-Díez M, Soria J, García JJ. Altered cellular membrane fluidity levels and lipid peroxidation during experimental pancreas transplantation. J Bioenerg Biomembr 2012; 44:571-7. [PMID: 22986734 DOI: 10.1007/s10863-012-9459-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 05/30/2012] [Indexed: 12/13/2022]
Abstract
Although the pathogenesis of ischemia reperfusion (IR) injury is based on complex mechanisms, free radicals play a central role. We evaluated membrane fluidity and lipid peroxidation during pancreas transplantation (PT) performed in 12 pigs (six donors and six recipients). Fluidity was measured by fluorescence spectroscopy, and malondialdehyde (MDA) and 4-hydroxyalkenals (4-HDA) concentrations were used as an index of lipid oxidation. Pancreatic tissues were collected as follows: (A) donor, immediately before vascular clamping; (B) graft, following perfusion lavage with University of Wisconsin preservation fluid; (C) graft, after 16 h of cold ischemia; and (D) recipient, 30 min vascular postreperfusion. Fluidity and MDA and 4-HDA concentrations were similar in cases A, B, and C. However, there was significant membrane rigidity and increased lipid peroxidation after reperfusion (D). These findings suggest that reperfusion exaggerates oxidative damage and may account for the rigidity in the membranes of allografts during PT.
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Affiliation(s)
- F A García-Gil
- Department of Surgery, Gynaecology and Obstetrics, University of Zaragoza, Zaragoza, Spain
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Hegyi P, Rakonczay Z. The role of nitric oxide in the physiology and pathophysiology of the exocrine pancreas. Antioxid Redox Signal 2011; 15:2723-41. [PMID: 21777142 DOI: 10.1089/ars.2011.4063] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
SIGNIFICANCE Nitric oxide (NO), a ubiquitous gaseous signaling molecule, contributes to both pancreatic physiology and pathophysiology. RECENT ADVANCES The present review provides a general overview of NO synthesis, signaling, and function. Further, it specifically discusses NO metabolism and its effects in the exocrine pancreas and focuses on the role of NO in the pathogenesis of acute pancreatitis and pancreatic ischemia/reperfusion injury. CRITICAL ISSUES Unfortunately, the role of NO in pancreatic physiology and pathophysiology remains controversial in numerous areas. Many questions regarding the messenger molecule still remain unanswered. FUTURE DIRECTIONS Probably the least is known about the downstream targets of NO, which need to be identified, especially at the molecular level.
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Affiliation(s)
- Péter Hegyi
- First Department of Medicine, University of Szeged, Szeged, Hungary
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Wiessner R, Eisold S, Linnebacher M, Bünger C, Nizze H, Wacke R, Benz S, Schareck W, Klar E. Up-Regulation of ICAM-1 During Cold Ischemia Triggers Early Neutrophil Infiltration in Human Pancreas Allograft Reperfusion. Transplant Proc 2009; 41:3622-7. [DOI: 10.1016/j.transproceed.2009.05.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Accepted: 05/20/2009] [Indexed: 11/29/2022]
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Wu L, Paerhati. Ischemia-reperfusion injury and acute pancreatitis. Shijie Huaren Xiaohua Zazhi 2009; 17:2400-2404. [DOI: 10.11569/wcjd.v17.i23.2400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Though the pathogenesis of acute pancreatitis is still not entirely clear, animal experiments and clinical studies suggest that ischemia-reperfusion injury plays an important role in the development of acute pancreatitis. The combined action of microcirculatory disturbance, increased free radical production, intracellular calcium overload, inflammatory mediators, leukocyte-platelet interaction, intestinal endotoxemia and other factors leads to pancreatic ischemia-reperfusion injury. Thus, ischemia-reperfusion injury is fundamental to the pathogenesis of acute pancreatitis. In this article, we will review the mechanisms behind the development of pancreatic ischemia-reperfusion injury in acute pancreatitis.
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Neeff HP, von Dobschuetz E, Sommer O, Hopt UT, Drognitz O. In vivo quantification of oxygen-free radical release in experimental pancreas transplantation. Transpl Int 2008; 21:1081-9. [PMID: 18699844 DOI: 10.1111/j.1432-2277.2008.00740.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Reactive oxygen species (ROS) were drawn to the attention in the setting of organ transplantation when the 'injury hypothesis' postulated a link between oxidative stress and the activation of the innate immunity of the recipient. While the occurrence of ROS during organ transplantation is undoubted, their onset and magnitude remain largely unknown. We therefore measured ROS using a novel cyclic hydroxylamine spin probe CMH (1-hydroxy-3- methoxycarbonyl-2,2,5,5-tetramethylpyrrolidine) during syngeneic experimental pancreas transplantation in rats in vivo. Organs were subjected to two different cold preservation methods [University of Wisconsin preservation solution (UW) or normal saline] for 18 h. During the first 90 min of reperfusion, samples were collected and analysed using electron paramagnetic resonance signalling. Isolated blood-free perfused organs (IPO) were used for comparison. Analysis showed that it is feasible to detect ROS using CMH spin probes. While IPO organs displayed a very early ROS release, there was no ROS increase in the UW preserved group compared to NaCl. These findings were in line with conventional markers of organ damage such as serum lactate, glucose, potassium as well as tissue ATP levels. CMH spin probes might become a useful tool for the in vivo animal testing of antioxidative substances in models of solid organ transplantation.
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Affiliation(s)
- Hannes P Neeff
- Department of General and Digestive Surgery, Transplantation Surgery, University Hospital Freiburg, Freiburg, Germany.
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Li BF, Liu YF, Cheng Y, Zhang KZ, Li TM, Zhao N. Protective effect of inducible nitric oxide synthase inhibitor on pancreas transplantation in rats. World J Gastroenterol 2008; 13:6066-71. [PMID: 18023101 PMCID: PMC4250892 DOI: 10.3748/wjg.v13.45.6066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the effect of inducible nitric oxide synthase inhibitor, aminoguanidine, on pancreas transplantation in rats. METHODS A model of pancreas transplantation was established in rats. Streptozotocin-induced diabetic male Wistar rats were randomly assigned to sham-operation control group (n = 6), transplant control group (n = 6), and aminoguanidine (AG) treatment group (n = 18). In the AG group, aminoguanidine was added to intravascular infusion as the onset of reperfusion at the dose of 60 mg/kg, 80 mg/kg, 100 mg/kg body weight, respectively. Serum nitric oxide (NO) level, blood sugar and amylase activity were detected. Nitric oxide synthase (NOS) test kit was used to detect the pancreas cNOS and inducible NOS (iNOS) activity. Pancreas sections stained with HE and immunohistochemistry were evaluated under a light microscope. RESULTS As compared with the transplant control group, the serum NO level and amylase activity decreased obviously and the evidence for pancreas injury was much less in the AG group. The AG (80 mg/kg body weight) group showed the most significant difference in NO and amylase (NO: 66.0 +/- 16.6 vs 192.3 +/- 60.0, P < 0.01 and amylase: 1426 +/- 177 vs 4477 +/- 630, P < 0.01). The expression and activity of tissue iNOS, and blood sugar in the AG (80 mg/kg body weight) group were much lower than those in the transplant control group (iNOS: 2.01 +/- 0.23 vs 26.59 +/- 5.78, P < 0.01 and blood sugar: 14.2 +/- 0.9 vs 16.8 +/- 1.1, P < 0.01). CONCLUSION Selective iNOS inhibitor, aminoguanidine as a free radical, has a protective effect on pancreas transplantation in rats by inhibiting NO and reducing its toxicity.
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Affiliation(s)
- Bai-Feng Li
- Department of Surgery and Organ Transplant Unit, The First Affiliated Hospital, China Medical University, Shenyang 110001, Liaoning Province, China
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11
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Wang L, Ma Q, Chen X, Sha H, Ma Z. Effects of resveratrol on calcium regulation in rats with severe acute pancreatitis. Eur J Pharmacol 2007; 580:271-6. [PMID: 18031730 DOI: 10.1016/j.ejphar.2007.10.068] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2007] [Revised: 10/08/2007] [Accepted: 10/22/2007] [Indexed: 10/22/2022]
Abstract
Intracellular calcium overload plays a key role in severe acute pancreatitis. Resveratrol can decrease the severity of pancreatitis; however, the mechanism of action of resveratrol has not been determined. The aim of our study was to examine the relationship between calcium overload and the effects of resveratrol in severe acute pancreatitis. Animals were randomly divided into 3 groups: control group (sham operation), model group (0.1 ml/100 g of 3.5% sodium taurocholate used to induce severe acute pancreatitis), and treated group (treated with resveratrol, 10 mg/kg). In model group, the severity of pancreatitis was aggravated; this was evaluated by pancreatic weight/body weight and lung weight/body weight ratios, serum amylase activities, and pancreatic histopathological scoring; the Ca(2+)-Mg(2+)-ATPase and Ca(2+)-ATPase activities decreased while PLA(2) activity and [Ca(2+)](i) increased gradually with time. Compared to the control group, in the model group, these changes were observed in the pancreatic tissue at the 3 h time point and in the lung tissue at the 6 h time point. Resveratrol ameliorated the changes in the laboratory parameters and significantly reduced the pathological damage in the tissues at the corresponding time points. In conclusion, intracellular calcium overload leads to tissue damage in severe acute pancreatitis, and the beneficial effects of resveratrol appear to be mediated by reducing the intracellular calcium overload; this not only limits pancreatic cellular injury but also secondary lung injury.
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Affiliation(s)
- Liancai Wang
- Department of Hepatobiliary Surgery, First Hospital of Xi'an Jiaotong University, 1 Jiankang Road, Xi'an, 710061, Shaanxi Province, China
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Papakostas JC, Toumpoulis IK, Pappa LS, Arnaoutoglou HM, Kirou IE, Malamou-Mitsi VD, Kappas AM, Matsagas MI. PANCREATIC INJURY AFTER THORACOABDOMINAL AORTIC OCCLUSION IN A PORCINE MODEL. ANZ J Surg 2007; 77:474-9. [PMID: 17501890 DOI: 10.1111/j.1445-2197.2007.04098.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The aim of this study was to investigate pancreatic injury after 45 min of thoracoabdominal aortic occlusion in a porcine model. METHODS Twenty-four pigs were used. Six pigs underwent sham operation and 18 intravascular balloon thoracoabdominal aortic occlusions for 45 min. The animals were randomly killed at 12, 48 and 120 h after reperfusion. After killing, all pancreata were examined macroscopically for any signs of acute pancreatitis, whereas gland specimens were harvested for histological study to evaluate pancreatic injury (haematoxylin and eosin staining) and acinar cell apoptosis (Terminal deoxynucleotidyl transferase mediated dUTP Nick-End Labelling staining). RESULTS Pancreatic injury severity score was mildly increased in terms of oedematous features at 12 h after reperfusion, but normalized to sham levels by the second day and thereafter. Necrotic injury was not statistically significant at any time point. Acinar cell apoptotic index was mildly increased at 12 and 48 h, but showed a tendency to decrease towards sham levels by the fifth day. One animal developed acute pancreatitis. CONCLUSION Acute pancreatitis is unlikely to occur after 45 min of thoracoabdominal aortic occlusion. However, an early, mild oedematous and apoptotic injury that occurs subclinically seems to be a constant event. This injury might have clinical significance when combined with pre-existent pancreatic pathologies.
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Affiliation(s)
- John C Papakostas
- Department of Surgery-Vascular Surgery Unit, Medical School, University of Ioannina, Ioannina, Greece
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Chvanov M, Petersen OH, Tepikin A. Free radicals and the pancreatic acinar cells: role in physiology and pathology. Philos Trans R Soc Lond B Biol Sci 2006; 360:2273-84. [PMID: 16321797 PMCID: PMC1569596 DOI: 10.1098/rstb.2005.1757] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Reactive oxygen and nitrogen species (ROS and RNS) play an important role in signal transduction and cell injury processes. Nitric oxide synthase (NOS)-the key enzyme producing nitric oxide (NO)-is found in neuronal structures, vascular endothelium and, possibly, in acinar and ductal epithelial cells in the pancreas. NO is known to regulate cell homeostasis, and its effects on the acinar cells are reviewed here. ROS are implicated in the early events within the acinar cells, leading to the development of acute pancreatitis. The available data on ROS/RNS involvement in the apoptotic and necrotic death of pancreatic acinar cells will be discussed.
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Affiliation(s)
- M Chvanov
- The University of Liverpool The Physiological Laboratory Crown Street, Liverpool L69 3BX, UK.
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Abstract
BACKGROUND Severe acute pancreatitis is characterized by pancreatic necrosis, resulting in local and systemic inflammation. Pancreatitis affects both the systemic and pancreatic vasculature. This review focuses on the underlying processes involved in the changes of microvascular anatomy following acute pancreatitis. METHODS A Medline/PubMed search (January 1966 to December 2005) with manual cross-referencing was conducted. All relevant articles investigating the pancreatic microcirculatory anatomy and the effect of pancreatitis on the microcirculation were included. RESULTS The pancreas is susceptible to ischaemic insult, which can exacerbate acute pancreatitis. There is also increasing evidence of pancreatic and systemic microvascular disturbances in the pathogenesis of pancreatitis, including vasoconstriction, shunting, inadequate perfusion, and increased blood viscosity and coagulation. These processes may be caused or exacerbated by ischaemia-reperfusion injury and the development of oxygen-derived free radicals. CONCLUSION Acute pancreatitis impairs the pancreatic and systemic microcirculation, which is a key pathological process in the development of severe necrotizing disease.
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Affiliation(s)
- C M Cuthbertson
- Department of Surgery, University of Melbourne, Austin Hospital, Lance Townsend Building Level 8, Heidelberg, Victoria 3084, Australia.
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Kaiser GM, Heuer MM, Frühauf NR, Kühne CA, Broelsch CE. General handling and anesthesia for experimental surgery in pigs. J Surg Res 2005; 130:73-9. [PMID: 16289594 DOI: 10.1016/j.jss.2005.07.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2005] [Revised: 05/02/2005] [Accepted: 07/10/2005] [Indexed: 11/23/2022]
Abstract
The pig is a common large animal for experimental settings in many fields of surgery. In experimental surgery, there is a need for different narcotic procedures depending on the complexity of the surgical investigation. Narcotic procedures have to be safe, easy to handle, and should not influence the experimental results. We hereby present important aspects of handling and narcotic procedures for pigs. The aim of this publication is to supply an introduction for young surgical investigators who are planning or already have started investigations using pigs as an experimental animal. This publication is based on our institutional experience of narcotic and surgical procedures in more than 400 cases.
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Affiliation(s)
- Gernot M Kaiser
- Department of General Surgery and Transplantation Surgery, University of Duisburg-Essen, Essen, Germany.
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Schaser KD, Puhl G, Vollmar B, Menger MD, Stover JF, Köhler K, Neuhaus P, Settmacher U. In vivo imaging of human pancreatic microcirculation and pancreatic tissue injury in clinical pancreas transplantation. Am J Transplant 2005; 5:341-50. [PMID: 15643994 DOI: 10.1111/j.1600-6143.2004.00663.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Pancreatitis remains to be a major complication following clinical pancreas transplantation. We performed orthogonal polarized spectral (OPS) imaging for direct in vivo visualization and quantification of human pancreatic microcirculation in six healthy donors for living donor liver transplantation and 13 patients undergoing simultaneous pancreas-kidney transplantation. We further determined the impact of microvascular dysfunction during early reperfusion on pancreatic graft injury. Exocrine and endocrine pancreatic impairment was determined by analysis of serum lipase, amylase and C-peptide levels. Compared to normal pancreas in liver donors (homogeneous acinar perfusion) functional capillary density (FCD) and capillary red blood flow velocity of reperfused grafts were significantly decreased. Elevated CRP concentrations on day 2 post-transplant and serum lipase and amylase levels determined on days 4-5 significantly correlated with microvascular dysfunction during the first 30 min of graft reperfusion. Post-transplant serum C-peptide also correlated significantly with pancreatic capillary perfusion. OPS imaging allows to intra-operatively assess physiologic pancreatic microcirculation and to determine microcirculatory impairment during early graft reperfusion. This impairment correlated with the manifestation of post-transplant dysfunction of both exocrine and endocrine pancreatic tissue. OPS imaging may be used clinically to determine the efficacy of interventions, aiming at attenuating microcirculatory impairment during the acute post-transplant reperfusion phase.
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Affiliation(s)
- Klaus-D Schaser
- Department of Trauma and Reconstructive Surgery, Charité, Campus Virchow-Klinikum, Humboldt-Universität zu Berlin, Berlin, Germany.
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Obermaier R, Von Dobschuetz E, Benthues A, Ansorge N, Schareck W, Hopt UT, Benz S. Exogenous and Endogenous Nitric Oxide Donors Improve Post-Ischemic Tissue Oxygenation in Early Pancreatic Ischemia/Reperfusion Injury in the Rat. Eur Surg Res 2004; 36:219-25. [PMID: 15263827 DOI: 10.1159/000078856] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2003] [Accepted: 01/12/2004] [Indexed: 11/19/2022]
Abstract
INTRODUCTION In pancreatic ischemia/reperfusion (IR) injury (IRI) the role of nitric oxide (NO) is not completely understood. Using a rat model of normothermic in situ IRI, the effect of endogenous and exogenous NO donors on post-ischemic tissue oxygenation and tissue damage was investigated. METHODS IR was induced by 2-hour normothermic in situ ischemia of a pancreatic tail segment pedunculated on the splenic vessels with 2 h of reperfusion in an untreated, an L-arginine- and a sodium-nitroprusside-treated group (Wistar rats, n = 7/group). Animals without ischemia served as controls. Tissue oxygenation (pO(2ti)) was monitored using a pO2-sensitive Clark-type electrode. Histological investigation was performed following a semiquantitative score (edema, vacuolization, PMN infiltration, necrosis). Plasma lipase was another marker of organ damage. RESULTS The administration of L-arginine and sodium nitroprusside caused a significant amelioration of the decrease in pO2i) after reperfusion compared to IR animals (p < 0.05). Histological damage was also reduced in the NO donor groups (p < 0.05). After reperfusion, plasma lipase in the L-arginine-treated animals was significantly lower compared to IR and sodium nitroprusside (p < 0.05). CONCLUSIONS The administration of both endogenous and exogenous NO donors is protective in IRI of the rat pancreas which can be seen by an improvement in post-ischemic tissue oxygenation which indicates better nutritive tissue perfusion, amelioration of the histological tissue injury and, in L-arginine animals, lower lipase levels. NO donors could be useful in the prevention and reduction of the pancreatic IRI.
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Affiliation(s)
- R Obermaier
- Department of Surgery, University of Freiburg, Freiburg, Germany.
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Obermaier R, von Dobschuetz E, Muhs O, Keck T, Drognitz O, Jonas L, Schareck W, Hopt UT, Benz S. Influence of nitric oxide on microcirculation in pancreatic ischemia/reperfusion injury: an intravital microscopic study. Transpl Int 2004. [PMID: 15118815 DOI: 10.1111/j.1432-2277.2004.tb00430.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Recently, protective effects of nitric oxide donors in pancreatic ischemia/reperfusion (IRI) injury have been described. Their role in post-ischemic microcirculation was previously not investigated. Ischemia reperfusion was induced in an isolated pancreatic tail segment in situ. Animals were randomized to four experimental groups (n=7 animals/group), the control group (CO) received saline as placebo. Treatment groups received either sodium nitroprusside (SN) 5 min before until 2 h after reperfusion, L-arginine (LA) 30 min before reperfusion until 2 h after reperfusion or sodium nitroprusside and L-arginine (SNLA) together. After induction of ischemia (2 h) post-ischemic microcirculation was observed for 2 h by intravital-fluorescence microscopy. Functional-capillary density (FCD), leukocyte adherence in post-capillary venules (LAV) and histological damage were analysed. After reperfusion FCD decreased in all groups (P<0.05). FCD was significantly restored in all groups with administration of nitric oxide donors after reperfusion (P<0.05) as compared to CO without significant difference between the individual nitric oxide donor groups. Leukocyte adherence was significantly increased 1 h and 2 h after reperfusion (P<0.001) as compared to baseline, which was lower in all nitric oxide donor groups. Histological damage in the pancreatic tail-segment was significantly reduced in nitric oxide donor groups (P<0.01). Administration of nitric oxide donors might be useful in ischemia-reperfusion injury of the pancreas by its protective effect on microcirculation and inflammatory reaction.
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Affiliation(s)
- R Obermaier
- Department of Surgery, University of Freiburg, Hugstetter Strasse 55, 79106 Freiburg, Germany.
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Vollmar B, Menger MD. Microcirculatory dysfunction in acute pancreatitis. A new concept of pathogenesis involving vasomotion-associated arteriolar constriction and dilation. Pancreatology 2004; 3:181-90. [PMID: 12817573 DOI: 10.1159/000070727] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Brigitte Vollmar
- Department of Experimental Surgery, University of Rostock, Germany.
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Wullstein C, Drognitz O, Woeste G, Schareck WD, Bechstein WO, Hopt UT, Benz S. High levels of C-reactive protein after simultaneous pancreas-kidney transplantation predict pancreas graft-related complications and graft survival. Transplantation 2004; 77:60-4. [PMID: 14724436 DOI: 10.1097/01.tp.0000100683.92689.27] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Although pancreas graft-related complications are frequent after simultaneous pancreas-kidney transplantation (SPK), there are no parameters predicting the risk for these complications. METHOD A two-center retrospective study was performed in 97 patients who underwent SPK to investigate the peak serum value of c-reactive protein (CRP) during the first 72 hr after SPK in view of graft-related complications and graft survival. RESULTS Mean peak CRP was 115.6 +/- 71.5 mg/L. Mean peak CRP was higher in patients needing relaparotomy (n=31) (136.4 vs. 105.8 mg/L, P=0.048), especially when postoperative bleeding was excluded (P=0.015); in patients with graft pancreatitis (P=0.03); and in patients with graft loss (n=19; P<0.001) compared with patients without these complications. With a cut-off of peak CRP at the level of mean plus 1 SD (187.05 mg/L), there was a significantly higher incidence of relaparotomies (P=0.01; bleedings excluded: P=0.003), graft pancreatitis (P=0.03), and pancreas graft loss (P<0.0001) in patients with high peak CRP compared with patients with low peak CRP. No differences were noticed with regard to rejection rate, mortality, and kidney graft loss. CONCLUSION Our findings suggest that peak CRP is a helpful parameter in predicting pancreas graft-related complications and pancreas graft survival after SPK. Our results also stress the importance of early graft damage in pancreas transplantation.
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Affiliation(s)
- C Wullstein
- Department of Surgery, Ruhr-University Bochum, Knappschaftskrankenhaus, Bochum, Germany
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Obermaier R, von Dobschuetz E, Drognitz O, Hopt UT, Benz S. Ischemic preconditioning attenuates capillary no-reflow and leukocyte adherence in postischemic pancreatitis. Langenbecks Arch Surg 2004; 389:511-6. [PMID: 14716491 DOI: 10.1007/s00423-003-0443-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2003] [Accepted: 10/29/2003] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS Ischemic preconditioning (IPC) has been shown to protect several organs from ischemia-reperfusion injury. Postischemic microvascular dysfunction is considered to be the key mechanism of early graft pancreatitis after transplantation. The aim of the study was to determine whether brief ischemia and reperfusion before prolonged ischemia followed by reperfusion is protective in respect to microcirculatory derangement in postischemic pancreatitis. METHODS In an in-situ model of ischemia-reperfusion was induced in the isolated pancreatic tail segment. Wistar rats were randomized to one group ( n=7/group) with 2-h ischemia and reperfusion (I/R) and another group with 10-min ischemia and 10-min reperfusion (IPC) before the prolonged ischemia time. Microcirculation was observed for 2 h by intravital-fluorescence microscopy that analyzed functional capillary density and leukocyte adherence in postcapillary venules. Histological damage was quantified by a semiquantitative score (edema, vacuolization, PMN infiltration, necrosis). RESULTS IPC resulted in a significant improvement of functional capillary density (248+/-20 vs 372+/-8 cm(-1), P<0.001), a significant reduction in leukocyte adherence in postcapillary venules (476+/-79 vs 179+/-15 cells/mm(2), P<0.001) and in significantly lower histological damage (score 9+/-0.8 vs 5+/-1.4, P<0.001), when compared with the ischemia-reperfusion group. CONCLUSION IPC reduces pancreatic inflammatory reaction by preservation of postischemic microcirculation. Therefore, it might become a useful procedure before organ procurement in pancreas transplantation.
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Affiliation(s)
- R Obermaier
- Department of General and Visceral Surgery, Albert-Ludwigs-University, Hugstetter Strasse 55, 79106 Freiburg, Germany.
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Obermaier R, Drognitz O, Grub A, von Dobschuetz E, Schareck W, Hopt UT, Benz S. Endotoxin preconditioning in pancreatic ischemia/reperfusion injury. Pancreas 2003; 27:e51-6. [PMID: 14508141 DOI: 10.1097/00006676-200310000-00020] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
OBJECTIVES Prospective organ donors are exposed to various stress types. The effect of endotoxin pretreatment (ETX) on pancreatic ischemia/reperfusion injury (IRI) is unclear. We investigated, using a rat model of pancreatic IRI of an in situ isolated pancreatic tail segment, the effect of ETX on postischemic microcirculation and organ damage. METHODS Twenty-four hours before pancreatic dissection, either intraperitoneal application of ETX (1 mg/kg in 0.9% NaCl) or saline only (control) was performed. Two-hour normothermic ischemia of the pancreatic tail was induced by clamping the splenic vessels and was followed by a reperfusion period of 2 hours. Microcirculatory parameters were measured by intravital epifluorescence microscopy [functional capillary density (FCD), adherent leukocytes (ALs), and histology]. The presented data represent the mean +/- SEM/SD as appropriate. RESULTS ETX pretreatment caused a significantly greater decrease in FCD (497 +/- 6 cm/cm2 baseline versus 326 +/- 15 cm/cm2 2 hours of reperfusion) compared with controls (498 +/- 8 versus 258 +/- 15 cm/cm2) 2 hours after reperfusion (P < 0.01). Two hours after reperfusion, ALs were significantly decreased in ETX animals compared with controls (ETX: 141 +/- 37 versus 273 +/- 36 cells/mm2, P < 0.05). Histologic damage was less in ETX (6.4 score points +/- 0.32 versus 8.8 +/- 0.33 control, P < 0.05). CONCLUSION ETX preconditioning decreases microcirculatory deterioration caused by IRI by means of less loss of nutritive tissue perfusion, decrease in ALs, and less histologic damage. This indicates a protective effect of ETX preconditioning in pancreatic IRI.
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Affiliation(s)
- Robert Obermaier
- Department of Surgery, University of Freiburg, Freiburg, Germany.
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