Mechanisms of action of hypertonic saline solution in experimental acute pancreatitis / Mecanismos de ação da solução salina hipertônica na pancreatite aguda experimental

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

INTRODUCTION: Severe acute pancreatitis (AP) is characterized by hemodynamic alterations and systemic inflammatory response leading to a high mortality rate. In AP the inappropriate activation of pancreatic enzymes plays an important role in pancreas autodigestion and in the inflammatory mechanisms responsible for the systemic response of the disease. In a previous study, we have demonstrated that hypertonic saline solution infusion significantly reduced mortality in experimental AP through an improvement in the hemodynamic conditions and by an antiinflammatory response, but its effects on the pancreatic lesions were not evaluated. The aim of the present study was to evaluate if the hypertonic saline solution reduces mortality in AP through a local effect attenuating the pancreatic lesion and/or by reducing the systemic inflammatory response syndrome (SIRS). METHODS: An experimental model of severe AP by injection of 0.5ml of 2.5% sodium taurocholate into the pancreatic duct was utilized. A hundred and forty two male Wistar rats were divided into 4 groups: C (control, without AP), ST (no treated AP), SSF (animals received 34ml/kg of normal saline solution of NaCl 0.9% IV, 1 hour after AP), and SSH (animals received 4ml/Kg of hypertonic saline solution of NaCl 7.5% IV, 1 hour after AP). After 2, 12 and 24 hours of induction of AP volume of ascitic fluid, trypsinogen activation peptides (TAP) levels and amylase activity in ascitic fluid and serum were determined. Pancreatic lipid peroxidation (MDA), myeloperoxidase (MPO) activity, and pancreatic histology were analysed 2 and 24 hours after AP. TNF-, IL-6, and IL-10 levels in ascitic fluid, serum, and pancreatic tissue were also analyzed. RESULTS: There were no significant differences in TAP levels and amylase activity in the ascitic fluid and serum in animals of groups ST, SSF and SSH. No differences in pancreatic MPO, MDA and histological score were observed among these three groups with AP. In the SSH group it was observed a significant decrease in volume of ascitic fluid and inflammatory cytokines levels (TNF-, IL-6, and IL-10) in ascitic fluid, serum, and pancreatic tissue when compared to ST and SSF groups (p<0.05). CONCLUSIONS: These findings suggest that hypertonic saline solution decreases local and systemic inflammatory response in acute pancreatitis without changing the intensity of the pancreatic lesions.

ASSUNTO(S)

citocinas solução salina hipertônica sirs sirs pancreatite cytokines inflammation pancreatitis saline solution hypertonic inflamação

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