Parecoxib Improves the Outcomes of Acute Mild and Moderate Pancreatitis: A 3-Year Matched Cohort Study Based on a Prospective Database

Peri-onset non-steroidal anti-inflammatory drugs use and organ failure in acute pancreatitis: A multicenter retrospective analysis

BACKGROUND

Organ failure (OF) of acute pancreatitis (AP) significantly contributes to AP-related mortality. Non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with reduced complications of AP.

AIMS

We aimed to investigate whether NSAIDs ameliorates SIRS and OF in patients with AP.

METHODS

Eligible patients with AP were retrospectively identified in 4 hospitals between January 2015 and December 2018. Associations between peri-onset NSAIDs use (day -3 to day 3) and OF, persistent OF (POF), and SIRS within the first week were analyzed. Propensity score-matched (PSM) analysis and inverse probability of treatment-weighted (IPTW) analysis were used to estimate risk ratios.

RESULTS

Among 1,528 patients with AP (97 [6.3%] with NSAIDs use), 242 (15.8%) developed organ failure, 89 (5.8%) progressed to POF, and 27 (1.8%) died within 3 months. PSM analysis showed no association between peri-onset NSAIDs and OF (risk ratio [RR], 1.00; 95% confidence interval [CI], 0.46 to 2.15) and POF (RR, 0.80; 95% CI, 0.21 to 2.98). IPTW analysis yielded similar results. Patients with and without peri-onset NSAIDs use were comparable with respect to OF, POF, and SIRS across subgroups defined by COX-2 selectivity and dose.

CONCLUSION

Peri-onset NSAIDs use was not significantly associated with reduced OF.

Parecoxib attenuates inflammation injury in septic H9c2 cells by regulating the MAPK signaling pathway

Parecoxib, a non-steroidal anti-inflammatory drug, has been reported to possess protective effects against sepsis. However, its detailed role and underlying mechanisms in septic cardiomyopathy remain unclear. Therefore, the goal of the present study was to clarify the function and to investigate the mechanisms of parecoxib in lipopolysaccharide (LPS)-treated H9c2 rat cardiomyocytes. TNF-α, IL-1β and IL-6 expression levels in parecoxib-treated H9c2 cells stimulated with LPS were assessed using ELISA. Parecoxib-treated H9c2 cells stimulated with LPS were tested for viability using the Cell Counting Kit-8 assay. Western blotting analysis and 5-ethynyl-2'-deoxyuridine were used to evaluate cell proliferation. Apoptosis was assessed using TUNEL and western blotting. To assess the protein expression of the MAPK signaling pathway, western blotting was performed. The data showed that parecoxib significantly and dose-dependently reduced the inflammatory responses of LPS-treated H9c2 cells. Parecoxib also significantly and dose-dependently increased the proliferation and inhibited the apoptosis of LPS-treated H9c2 cells. In addition, parecoxib significantly suppressed the activation of the MAPK (p38, JNK and ERK) signaling pathway. The current study indicated that parecoxib could be a viable therapeutic option for septic cardiomyopathy.

St13 protects against disordered acinar cell arachidonic acid pathway in chronic pancreatitis

BACKGROUND

Early diagnosis and treatment of chronic pancreatitis (CP) are limited. In this study, St13, a co-chaperone protein, was investigated whether it constituted a novel regulatory target in CP. Meanwhile, we evaluated the value of micro-PET/CT in the early diagnosis of CP.

METHODS

Data from healthy control individuals and patients with alcoholic CP (ACP) or non-ACP (nACP) were analysed. PRSS1 transgenic mice (PRSS1^Tg) were treated with ethanol or caerulein to mimic the development of ACP or nACP, respectively. Pancreatic lipid metabolite profiling was performed in human and PRSS1^Tg model mice. The potential functions of St13 were investigated by crossing PRSS1^Tg mice with St13^-/- mice via immunoprecipitation and lipid metabolomics. Micro-PET/CT was performed to evaluate pancreatic morphology and fibrosis in CP model.

RESULTS

The arachidonic acid (AA) pathway ranked the most commonly dysregulated lipid pathway in ACP and nACP in human and mice. Knockout of St13 exacerbated fatty replacement and fibrosis in CP model. Sdf2l1 was identified as a binding partner of St13 as it stabilizes the IRE1α-XBP1s signalling pathway, which regulates COX-2, an important component in AA metabolism. Micro-PET/CT with ⁶⁸Ga-FAPI-04 was useful for evaluating pancreatic morphology and fibrosis in CP model mice 2 weeks after modelling.

CONCLUSION

St13 is functionally activated in acinar cells and protects against the cellular characteristics of CP by binding Sdf2l1, regulating AA pathway. ⁶⁸Ga-FAPI-04 PET/CT may be a very valuable approach for the early diagnosis of CP. These findings thus provide novel insights into both diagnosis and treatment of CP.

Effect of Parecoxib on Hippocampus and Hypothalamic Orexin Neurons in Rats with Cerebral Infarction

Cerebral infarction has seriously threatened human life and health. Parecoxib is the first nonsteroidal analgesic for surgical analgesia. However, its effect on orexin neurons during cerebral infarction treatment is unclear. In this study, a rat model of cerebral infarction was established by suture method. The experiment was assigned into sham operation group, cerebral infarction model group (MCAO), high and low dose group of parecoxib. Western blotting and immunofluorescence staining was used to evaluate the activity of orexin neurons. The infarct size was evaluated by TTC staining. The apoptosis of neurons in hypothalamus and hippocampus was determined by AV-PI staining. TTC staining suggested that parecoxib treatment significantly reduced cerebral infarct size, increased orexin neuronal activity, and decreased neuronal apoptosis in hypothalamus and hippocampus, which were significantly different from sham-operated groups. This study demonstrates that parecoxib has a protective effect on cerebral infarction rats, which can inhibit the apoptosis of hypothalamic and hippocampal neurons through the orexin neuron pathway. It provides a theoretical basis for the protective effect of parecoxib, indicating that it might be a new target for the treatment of cerebral infarction.