Octreotide ameliorates glucose intolerance following acute experimental pancreatitis

Infliximab enhances the therapeutic effectiveness of octreotide on acute necrotizing pancreatitis in rat model

OBJECTIVES

To investigate the synergistic activity of infliximab to the therapeutic effectiveness of octreotide in a rat model of acute necrotizing pancreatitis (ANP).

METHODS

Forty Sprague-Dawley rats were randomly divided into sham-operated group (SO), ANP group (ANP), octreotide group (OG), infliximab group (IG), and combination group (CG) (n = 8 in each group). The ANP model was induced by biliopancreatic duct injection with 4.5% of sodium taurocholate solution. Rats of the OG, IG, and CG were given a tail vein injection of octreotide (10 μg/kg), infliximab (8 mg/kg), and infliximab (8 mg/kg), respectively, combined with octreotide (10 μg/kg) at 6 hours after modeling. All rats in each group were killed at 24 hours after modeling. Serum biochemical indicator and partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) of rats were determined. Pathological severity score of organs were evaluated.

RESULTS

The serum biochemical indicator and organs' pathology score of OG , IG, and CG were obviously lower than those in the ANP group, and those in the CG were the lowest (P < 0.05). The PaO2/FiO2 levels in the OG, IG, and CG were significantly higher than that in the ANP group (P < 0.05).

CONCLUSION

Infliximab could significantly lower the serum biochemical indicator, improve organs' function, and enhance the therapeutic effectiveness of octreotide on ANP.

Human interleukin 10 gene therapy decreases the severity and mortality of lethal pancreatitis in rats

BACKGROUND

Studies have proven the validity of interleukin-10 (IL-10) in the treatment of experimental pancreatitis. Prophylactic human IL-10 (hIL-10) gene treatment attenuated the severity in cerulein models. Our research aims to study whether the therapeutic hIL-10 gene could decrease both severity and mortality in a lethal pancreatic model.

METHODS

Severe acute pancreatitis (SAP) was induced by sodium taurocholate. A plasmid-hIL-10 construct (pcDNA3-hIL-10) complexed with cationic liposomes was administered to SAP rats by a single intraperitoneal injection. Levels of hIL-10 in the pancreas, liver, and lungs were determined by ELISA kits. The severity of pancreatitis was assessed in terms of serum amylase, histology, and tissue tumor necrosis factor alpha (TNF-alpha). Mortality, observed for 7 days, was evaluated for gene therapy or control groups.

RESULTS

After hIL-10 gene therapy, hIL-10 levels in the pancreas, liver, and lungs increased significantly and the serum amylase, tissue TNF-alpha, and histological changes in pancreas, liver, and lungs decreased markedly. Therefore, mortality was significantly reduced in the hIL-10 gene therapy group, in which 70% of rats survived in the 7-day observation, while only 10% survived in untreated groups (P < 0.05).

CONCLUSION

We found that liposome/hIL-10 gene therapy decreased severity and mortality in SAP, even carried out after SAP establishment, predicting a more convenient shift to clinical applications.

Interkukin-10 Attenuates Proinflammatory Cytokine Production and Improves Survival in Lethal Pancreatitis

Given that interleukin (IL)-10 (IL-10) serves as a potent down-regulator of specific proinflammatory cytokines we reasoned that its administration should improve outcome in situations in which the biological response to a severe inflammatory challenge is the critical determinant of survival. To test our hypothesis we administered IL-10 in the setting of lethal pancreatitis to determine its effect on proinflammatory cytokine production and survival. We divided Sprague-Dawley rats into three groups. Controls (Group 1, n = 5) received a sham laparotomy. We induced pancreatitis in Group 2 (n = 9) and Group 3 (n = 9) via laparotomy and intrapancreatic infiltration of one mL of 5 per cent sodium taurocholate. Group 2 was treated only with saline, whereas Group 3 was treated with 10,000 units of IL-10 (in saline) at 30 minutes, 3.5 hours, and 6.5 hours after induction of pancreatitis. Serial blood samples were obtained at 6.5 hours for measurement of amylase, IL-1, and IL-6. The Kaplan-Meier method, Wilcoxon test, and Student's t test were used for analysis. Seven-day survival was 100, 0, and 45 per cent in Groups 1, 2, and 3, respectively. Production of amylase, IL-1, and IL-6 was lower in the IL-10-treated group (Group 3) compared with the group treated with saline alone (Group 2, P < 0.05). We conclude that administration of IL-10 in the setting of otherwise 100 per cent lethal experimental pancreatitis significantly reduces production of amylase, IL-1, and IL-6 and improves survival.

The effects of somatostatin and octreotide on experimental and human acute pancreatitis

The role of somatostatin and octreotide for AP has been studied for two decades, yet the data still remain inconclusive. The inconsistencies of the results of experimental studies and clinical trials may stem from the fact that the optimal therapeutic modality has not been determined. Furthermore, although they are similar in structure and physiologic activities, the mechanisms of action and effects of somatostatin and octreotide in AP may be different. Because the data are sparse, most reports, primarily those in the English literature, on the efficacy of somatostatin and octreotide in the management of AP were reviewed. Included are both nonrandomized and prospective, double-blind, clinical trials and studies on the effects of these agents on various experimental models of the disease. The results of the studies on somatostatin and octreotide are presented and discussed separately, with specific reference to the experimental and treatment details. The main focus of the review is the effect of subcutaneous and intravenous administration of octreotide. Analysis of the data suggests that somatostatin could not be recommended for AP and that the efficacy of subcutaneous administration of octreotide is also questionable. Theoretically, intravenous octreotide may be more appropriate for this condition, but recent results with this therapeutic method are limited and contradictory. Studies that would delineate the optimal therapeutical modality and the patient population most likely to respond to the treatment are prerequisite for large-scale clinical trials on the effects of octreotide on human pancreatitis.