Reposição volêmica com soluções salinas em pancreatite e perfil hepático de proteínas apoptóticas e de choque térmico.
Rev Bras Ter Intensiva 2012;
24:326-33. [PMID:
23917928 PMCID:
PMC4031807 DOI:
10.1590/s0103-507x2012000400006]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 10/31/2012] [Indexed: 11/21/2022] Open
Abstract
Objective
Liver failure can occur as a consequence of the systemic inflammation after acute
pancreatitis. We assessed the effect of volume repositioning with hypertonic
saline solution or normal saline on hepatic cytokine production and the expression
of heat-shock proteins and apoptotic proteins after acute pancreatitis.
Methods
Wistar rats were divided in four groups: C - control animals that were not
subjected to insult or treatment; NT - animals that were subjected to acute
pancreatitis and received no treatment; normal saline - animals that were
subjected to acute pancreatitis and received normal saline (NaCl 0.9%); and HS -
animals that were subjected to acute pancreatitis and received hypertonic saline
solution (NaCl 7.5%). Acute pancreatitis was induced by retrograde transduodenal
infusion of 2.5% sodium taurocholate into the pancreatic duct. At 4, 12 and 24 h
following acute pancreatitis induction, TNF-alpha, IL-1-beta, IL-6 and IL-10,
caspase-2 and -7, Apaf-1, AIF and HSP60 and 90 were analyzed in the liver.
Results
Casp2 decreased in the normal saline and hypertonic saline groups (p<0.05
versus. C) at 12 h. Apaf-1, AIF and HSP90 remained unchanged.
At 4 h, Casp7 increased in the NT group (p<0.01 versus C),
although it remained at the baseline levels in the reperfused groups. HSP60
increased in all of the groups at 4 h (p<0.0.001 vs. C).
However, the hypertonic saline group showed lower expression of HSP60 than the
normal saline group (p<0.05). Hypertonic saline solution maintained the
production of cytokines at normal levels. Volume reperfusion with normal or
hypertonic saline significantly modulated the expression of Casp7.
Conclusion
Volume replacement with hypertonic or normal saline was effective in reducing
caspase 7. However, only hypertonic solution was capable of regulating cytokine
production and HSP60 expression at all time points.
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