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

Yıl 2021, , 395 - 399, 29.12.2021
https://doi.org/10.35440/hutfd.985720

Öz

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: 

Kaynakça

  • 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.

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

Yıl 2021, , 395 - 399, 29.12.2021
https://doi.org/10.35440/hutfd.985720

Öz

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.

Kaynakça

  • 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.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Araştırma Makalesi
Yazarlar

Hasan Elkan 0000-0003-3781-7527

Hüsnü Sönmez 0000-0002-5993-9536

Figen Doran 0000-0002-2757-2119

Besim Özaykan 0000-0001-9878-340X

Atılgan Tolga Akçam

İsmail Cem Eray

Orçun Yalav

Yayımlanma Tarihi 29 Aralık 2021
Gönderilme Tarihi 22 Ağustos 2021
Kabul Tarihi 19 Ekim 2021
Yayımlandığı Sayı Yıl 2021

Kaynak Göster

Vancouver Elkan H, Sönmez H, Doran F, Özaykan B, Akçam AT, Eray İC, Yalav O. Effect of N Acethylcystein and Methylprednisolone on Acute Pancratitis and Lung Complications in Experimental Acute Pancratitis Model. Harran Üniversitesi Tıp Fakültesi Dergisi. 2021;18(3):395-9.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty