Effect of N Acethylcystein and Methylprednisolone on Acute Pancratitis and Lung Complications in Experimental Acute Pancratitis Model

Year 2021, , 395 - 399, 29.12.2021

Hasan Elkan , Hüsnü Sönmez , Figen Doran , Besim Özaykan , Atılgan Tolga Akçam , İsmail Cem Eray , Orçun Yalav

https://doi.org/10.35440/hutfd.985720

Abstract

Background: This study aims to determine N-acetyl cysteine (NAC) and methylprednisolone effects on the lung and pancreas in an experimental acute pancreatitis model.
Materials and Methods: A total of 64 male Wistar albino rats weighing 175-240 g were included in the study. Four groups of an equal number of rats (n=16) were formed. For the control group, 80 mcg/kg saline was injected into group 1. 80 mcg/kg cerulein was used to induce pancreatitis in groups 2, 3, and 4. Group 3 received NAC (1,000 mg/kg) and group 4 received methylprednisolone (5 mg/kg). Decapitation was applied to half of the groups after 7 hours (short term) and the other half after 24 hours (long term). Blood amylase and lipase values were examined. Edema in the pancreatic tissue was evaluated using the Schönberg scor-ing. Lung tissue was evaluated using scoring ranging from 0 to 3.
Results: Pancreatitis was successfully induced in all subjects in groups 2, 3, and 4. Amylase and lipase values of group 3 and group 4 were lower than group 2 in the short term (p <0.005). For short-term results, sub-jects given methylprednisolone and NAC exhibited better histopathological status in both pancreas and lungs (p = 0.001; p = 0.019, respectively). Only the pancreatic Schönberg score was significantly lower in the methylprednisolone treatment group (p = 0.0001).
Conclusions: Our study revealed that NAC and methylprednisolone have positive effects in the short term both biochemically and histopathologically in the treatment of acute pancreatitis and related respiratory complications.

Key Words: 

Keywords

Acute pancreatit, N-acetyl cysteine, Methylprednisolone, Acute pancreatit, N-acetyl cysteine, Methylprednisolone

Deneysel Akut Pankreatit Modelinde N Asetilsistein İle Metilprednisolon’un Akut Pankreatit ve Akciğer Komplikasyonları Üzerine Etkisi

Abstract

Amaç: Bu çalışma, deneysel akut pankreatitte N-asetil sisteinin (NAC) ve metilprednizolonun, akciğer ve pankreas üzerindeki etkilerini belirlemeyi amaçlamaktadır.
Gereç ve Yöntemler: Çalışmaya 175-240 gr ağırlığında toplam 64 adet erkek Wistar albino sıçan dahil edildi. Eşit sayıda sıçan (n = 16) olan dört grup oluşturuldu. Kontrol grubu için grup 1'e 80 mcg/kg salin enjekte edildi. Grup 2,3 ve 4'te pankreatiti indüklemek için 80 mcg/kg serulein kullanıldı. Grup 3'e NAC (1,000 mg/kg) ve Grup 4'e metilprednizolon (5 mg/kg) verildi. Grupların yarısına 7 saat sonra (kısa dönem), diğer yarısına 24 saat sonra (uzun dönem) dekapitasyon uygulandı. Kan amilaz ve lipaz değerleri incelendi. Pankreas dokusundaki ödem, Schönberg skorlaması kullanılarak değerlendirildi. Akciğer dokusu, 0 ila 3 arasında değişen puanlama kullanılarak değerlendirildi.
Bulgular: Grup 2, 3 ve 4'te tüm deneklerde pankreatit başarıyla indüklendi. Grup 3 ve grup 4'ün amilaz ve lipaz değerleri grup 2'ye göre kısa dönemde daha düşüktü (p <0,005). Kısa dönem sonuçlar için, metilprednizolon ve NAC verilen denekler hem pankreasta hem de akciğerlerde daha iyi histopatolojik durum sergiledi (sırasıyla p = 0.001; p = 0.019). Uzun dönem sonuçlar için, metilprednizolon tedavi grupunda sadece pankreas Schönberg skoru anlamlı olarak daha düşüktü (p = 0.0001).
Sonuç: Çalışmamız, akut pankreatit ve buna bağlı solunumsal komplikasyonların tedavisinde NAC ve metilprednizolon hem biyokimyasal hem de histopatolojik olarak kısa vadede olumlu etkileri olduğu ortaya koymuştur.

Keywords

acute pancreatit, N-acetyl cystein, metylprednisolon

References

• 1- Roberts SE, Akbari A, Thorne K, Atkinson M, Evans PA. The incidence of acute pancreatitis: impact of social deprivation, alcohol consumption, seasonal and demographic factors. Aliment Pharmacol Ther 2013; 38: 539-48.
• 2- Banks PA, Freeman ML. Practice Parameters Committee of the American College of Gastroenterology. Practice guidelines in acute pancreatitis. Am J Gastroenterol 2006; 101: 2379-400.
• 3- Ranson JH, Turner JW, Roses DF, Rifkind KM, Spencer FC. Respiratory complications in acute pancreatitis. Ann Surg 1974; 179: 557-66.
• 4- Kruse P, Anderson ME, Loft S. Minor role of oxidative stress durıng intermediate phase of acute pancreatitis in rats. Free Radical Biology & Medicine 2001; 30: 309-17.
• 5- Sala R, Moriggi E, Corvasce G, Morelli D. Protection by N-acetylcysteine against pulmonary endothelial cell damage by oxidant injury. Eur Respir J 1993; 6: 440-6.
• 6- Pezzilli R, Fantin L. Glucocorticoids and Acute Pancreatitis: Suggestions for Future Clinical Trials. JOP. J Pancreas (Online)2006; 7: 249-51.
• 7- Schoenberg MH, Büchler M, Gaspar M, Stinner A. Oxygen free radicals in acute pancreatits of the rat. Gut 1990; 31: 1138-43.
• 8- Balkan A, Balkan M, Yasar M, Korkmaz A, Erdem O, Kılıc S, et al. Pulmonary Protective Effects of Hyberbaric Oxygen and N-Acetylcysteine Treatment in Necrotizing Pancreatitis. Physiol Res 2006: 55; 25-31.
• 9- Karne S, Gorelik FS. Etiopathogenesis of acute pancreatitis. Surgical Clinics Of North America 1999; 79: 44: 699-709.
• 10- Boxhoorn L, Voermans RP, Bouwense SA, Bruno MJ, Verdonk RC, Boermeester MA, et al. Acute pancreatitis. Lancet 2020; 396: 726-34.
• 11- Guice KS, Oldham KT, Caty MG, Johnson KJ, Ward PA. Neutrophil-dependent, oxygen-radical mediated lung injury associated with acute pancreatitis. Ann Surg. 1989; 210: 740-7.
• 12- O'Donovan DA, Kelly CJ, Abdih H, Bouchier-Hayes D, Watson RW, Redmond HP, et al. Role of nitric oxide in lung injury associated with experimental acute pancreatitis. Br J Surg 1995; 82: 1122-6.
• 13- Choi JY, Kim KH. Effects of small molecular antioxidants on cerulein-induced acute pancreatitis in rat. Korean J Physiopharmacol 1998; 2: 629-35.
• 14- Demols A, Van Laethem JL, Quertinmont E, Legros F, Louis H, Le Moine O, et al. N-acetylcysteine decreases severity of acute pancreatitis in mice. Pancreas. 2000; 20: 161-9.
• 15- Gloor B, Uhl W, Tcholakov O, Roggo A, Muller CA, Worni M, et al. Hydrocortisone treatment of early SIRS in acute experimental pancreatitis. Dig Dis Sci 2001; 46: 2154-61.
• 16- Abe R, Shimosegawa T, Kimura K, Abe T, Kashimura J, Koizumi M, et al. The role of endogenous glucocorticoids in rat experimental models of acute pancreatitis. Gastroenterology 1995; 109: 933-43.
• 17- Osman MO, Jacobsen NO, Kristensen JU, Larsen CG, Jensen SL. Beneficial effects of hydrocortisone in a model of experimental acute pancreatitis. Dig Surg 1999; 16: 214-21.
• 18- Sun W, Watanabe Y, Toki A, Wang ZQ. Beneficial effects of hydrocortisone in induced acute pancreatitis of rats. Chin Med J (Engl) 2007; 120: 1757-61.
• 19- Kuraishi Y, Uehara T, Watanabe T, Ashihara N, Ozawa M, Kanai K, et al. Corticosteroids prevent the progression of autoimmune pancreatitis to chronic pancreatitis. Pancreatology 2020; 20: 1062-8. 20- Matsubayashi H, Ishiwatari H, Imai K, Kishida Y, Ito S, Hotta K, et al. Steroid Therapy and Steroid Response in Autoimmune Pancreatitis. Int J Mol Sci 2019; 21: 257.
• 21- Takaoka K, Kataoka K, Sakagami J. The effect of steroid pulse therapy on the development of acute pancreatitis induced by closed duodenal loop in rats. J Gastroenterol 2002; 37: 537-42.