Study on protecting effects of Baicalin and Octreotide on hepatic injury in rats with severe acute pancreatitis

Liver injury associated with acute pancreatitis: The current status of clinical evaluation and involved mechanisms

Acute pancreatitis (AP) is a very common acute disease, and the mortality rate of severe AP (SAP) is between 15% and 35%. The main causes of death are multiple organ dysfunction syndrome and infections. The mortality rate of patients with SAP related to liver failure is as high as 83%, and approximately 5% of the SAP patients have fulminant liver failure. Liver function is closely related to the progression and prognosis of AP. In this review, we aim to elaborate on the clinical manifestations and mechanism of liver injury in patients with AP.

Chinese Herbal Medicines Attenuate Acute Pancreatitis: Pharmacological Activities and Mechanisms

Acute pancreatitis (AP) is a commonly occurring gastrointestinal disorder. An increase in the annual incidence of AP has been observed, and it causes acute hospitalization and high mortality. The diagnosis and treatment guidelines for AP recommend conservative medical treatments focused on reducing pancreatic secretion and secondary injury, as a primary therapeutic approach. Unfortunately, the existing treatment options have limited impact on the incidence and severity of AP due to the complex and multifaceted pathological process of this disease. In recent decades, Chinese herbal medicines (CHMs) have been used as efficient therapeutic agents to attenuate AP in Asian countries. Despite early cell culture, animal models, and clinical trials, CHMs are capable of interacting with numerous molecular targets participating in the pathogenesis of AP; however, comprehensive, up-to-date communication in this field is not yet available. This review focuses on the pharmacological activities of CHMs against AP in vitro and in vivo and the underlying mechanisms. A computational prediction of few selected and promising plant-derived molecules (emodin, baicalin, resveratrol, curcumin, ligustrazine, and honokiol) to target numerous proteins or networks involved in AP was initially established based on a network pharmacology simulation. Moreover, we also summarized some potential toxic natural products for pancreas in order to more safe and reasonable medication. These breakthrough findings may have important implications for innovative drug research and the future development of treatments for AP.

The diffuse reduction in spleen density: an indicator of severe acute pancreatitis?

We observed that acute pancreatitis (AP) was associated with diffuse reduction in spleen density (DROSD) in some patients. Furthermore, the condition of these patients was more serious, and the potential relationship between DROSD and structural and functional injury of the spleen remained unclear. Therefore, we performed a preliminary exploration of these factors. We analysed pertinent clinical data for AP patients with normal spleen density (control group) and for those with DROSD (reduction group) at the First Affiliated Hospital of Harbin Medical University (June 2013–June 2015). We measured the immunoglobulin M (IgM) B-cells of the AP patients and examined pancreatic and splenic tissues from AP rats with optical microscopy and TEM. The reduction group had a higher acute physiology and chronic health evaluation II (APACHE II) score, a longer length of stay (LOS) and lower serum calcium than the control group. The levels of triglycerides (TG) and total cholesterol (TC) did not differ significantly between the two groups. The percentage of IgM memory B-cells was significantly lower in the DROSD group than in the control group. TEM revealed that the spleen T-lymphocytes were normal in AP rats, but pyroptotic and necrotic spleen B-cells were observed in the severe AP rats. In AP, DROSD was an independent indicator of more severe conditions. Furthermore, spleen B-lymphocytes showed obvious damage at the cellular level, and the immunological function of the spleen was down-regulated when AP was associated with DROSD.

Research on scutellarin parenteral solution's protective effects in rats with severe acute pancreatitis and multiple organ injuries

The aim of this study was to observe scutellarin parenteral solution's therapeutic effects and mechanisms in rats with severe acute pancreatitis (SAP). We divided SD rats into four groups randomly: (1) sham-operated group, (2) model control group, (3) scutellarin-treated group, and (4) Salvia miltiorrhiza-treated group. All of those rats in the abovementioned groups are randomly subdivided into 6 and 12 h subgroups, respectively, according to the postoperative time. Rats have been mercifully killed at different time after operation, and then detected their serum amylase, contents of ALT, AST, BUN, and Cr and observed the pathologic changes of multiple organs (pancreas, liver, kidneys, and lungs). We found that the survival rates have no marked differences (P < 0.05) between model control group and two treated groups at any time points. AST and BUN serum contents have no marked difference (P > 0.05). ALT serum contents in S. miltiorrhiza-treated group (6 and 12 h) and scutellarin-treated group (12 h) are obviously less than those in model control group (P < 0.05). The serum contents of Cr and amylase in scutellarin-treated group (6 h) are obviously less than those in model control group (P < 0.05). There is a different degree of relief on the pathologic changes of multiple organs in the two treated groups compared with those in model control group, of which pancreas and liver's pathologic severity scores in scutellarin-treated group (6 and 12 h) have reduced (P < 0.01) significantly compared with those in the model control group. However, there are no significant differences between scutellarin-treated group and S. miltiorrhiza-treated group (P > 0.05). We think the scutellarin parenteral solution has a certain protective effect on SAP rats' multiple organ injuries.

Continuous regional arterial infusion with fluorouracil and octreotide attenuates severe acute pancreatitis in a canine model

Aim

To investigate the therapeutic effects of fluorouracil (5-Fu) and octreotide (Oct) continuous regional arterial infusion (CRAI,) alone or in combination, was administered in a canine model of severe acute pancreatitis (SAP).

Materials and Methods

The animals were divided into five groups; group A (Sham), group B (SAP), group C (SAP and 5-Fu), group D (SAP and Oct), and group E (SAP and 5-Fu + Oct). Levels of amylase, α-tumor necrosis factor (TNF-α), blood urea nitrogen (BUN), creatinine, thromboxane B2 and 6-keto- prostaglandin F1α were measured both before and after the induction of SAP. Pathologic examination of the pancreas and kidneys was performed after termination of the study.

Results

Pathologic changes noted in the pancreas in SAP significantly improved following CRAI with either single or combined administration of 5-Fu and Oct, where combination therapy demonstrated the lowest injury score. All treatment groups had significantly lower levels of serum TNF-α and amylase activity (P<0.05), though only groups D and E had a lower BUN level as compared to group B. The plasma thromboxane B₂ level increased in SAP, but the ratio of thromboxane B₂/6-keto- prostaglandin F_1α decreased in the treatment groups, with the combination therapy (group E) demonstrating the lowest ratio as compared to the other 3 experimental groups (P<0.05).

Conclusions

The findings in the present study demonstrate an attenuation of SAP in a canine model following CRAI administration with 5-Fu or Oct, alone or in combination.

α-lipoic acid reduces liver injury in rats with acute pancreatitis

AIM: To explore the inhibitory effect of α-lipoic acid (ALA) on hepatic injury in rats with acute pancreatitis (AP).

METHODS: A rat model of AP was established by retrograde injection of 3.5% sodium taurocholate into the biliopancreatic duct. Fifty-four Wistar rats (n = 54) were randomly divided into three groups: sham-operation group (SO group, n = 18), acute pancreatitis group (AP group, n = 18), and ALA treatment group (ALA group, n = 18). The ALA group was intraperitoneally injected with 1 mg/kg ALA. Each group were further divided into 3 subgroups (n = 6) for testing at 3, 6 and 12 h after treatment. The levels of serum amylase, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were determined using an automatic biochemical analyzer. The SOD activity and MDA level in liver tissue were measured by colorimetry. Pancreatic gland and liver histological changes were evaluated by hematoxylin and eosin (HE) staining. The expression of ICAM-1 and VCAM-1 in liver tissue was determined by immunohistochemistry.

RESULTS: The levels of serum amylase, ALT, AST and hepatic MDA at all time points were significantly increased (3 h: 1 525.17 ± 370.36 vs 134.67 ± 37.46, 101.17 ± 22.33 vs 35.40 ± 5.71, 62.71 ± 19.16 vs 38.25 ± 4.63 and 2.83 ± 0.6 vs 2.12 ± 0.41, all P < 0.01 or 0.05) and SOD activity was decreased (3 h: 43.12 ± 5.87 vs 50.49 ± 7.08, P < 0.05) in the AP group compared with the SO group. Histological examination showed multifocal necrosis and inflammatory cell infiltration in the AP group. The expression of ICAM-1 and VCAM-1 in liver tissue was enhanced in the AP group, but was undetectable in the SO group. In the ALA group, the levels of serum amylase, ALT, AST and hepatic MDA were significantly decreased (3 h: 1 141.50 ± 617.01, 78.11 ± 15.50, 47.16 ± 12.25 and 2.37 ± 0.48, all P < 0.05) and SOD activity was increased (3 h: 45.36 ± 5.67, P < 0.05) compared with the AP group. Hepatic injury was improved and the expression of ICAM-1 and VCAM-1 was significantly decreased in the ALA group compared with the AP group.

CONCLUSION: ALA exerts a protective effect against hepatic injury in rats with acute pancreatitis possibly by resisting oxidation and decreasing hepatic expression of ICAM-1 and VCAM-1.

Influence of baicalin on TNF-alpha mRNA, caspase-3 and P-selectin expression in pancreatic tissue of rats with severe acute pancreatitis

OBJECTIVE

Baicalin reduces the severity of severe acute pancreatitis (SAP) in a rat model. This study was carried out to examine the effect of baicalin on TNF-alpha mRNA, caspase-3 and P-selectin protein expression in the pancreas of rats with SAP.

METHODS

Rats with SAP were randomly assigned to untreated, baicalin-treated, octreotide-treated and sham-operated group. The TNF-alpha mRNA expression level, caspase-3 and P-selectin protein expression levels of pancreatic tissue were measured 3, 6 and 12 hours after operation.

RESULTS

The caspase-3 protein expression level was significantly higher in the treated groups than that in the untreated group at 3 hours (p <0.01). P-selectin protein expression level in pancreas of the treated groups was significantly lower than that of the untreated group (p <0.05 or <0.01). TNF-alpha mRNA expression level in pancreas decreased in baicalintreated group while untreated group increased at different time points (p <0.05).

CONCLUSION

Baicalin increases caspase-3 expression and inhibits TNF-alpha mRNA and P-selectin protein expression in pancreatic tissue of SAP rats.

Effects of Baicalin on inflammatory mediators and pancreatic acinar cell apoptosis in rats with sever acute pancreatitis

BACKGROUND

To investigate the effects of Baicalin and Octreotide on inflammatory mediators and pancreatic acinar cells apoptosis of rats with severe acute pancreatitis (SAP).

METHODS

SD rats were randomly divided into sham operated group (I group), model control group (II group), Baicalin treated group (III group) and Octreotide treated group (IV group). Each group was also divided into subgroup of 3, 6 and 12 h (n = 15). The mortality rate, ascites/body weight ratio as well as the level of endotoxin, NO and ET-1 in blood were measured. The pathological severity score of pancreas, apoptotic indexes, and expression levels of Bax and Bcl-2 proteins in each group were investigated.

RESULTS

The survival rate of III and IV group has a significant difference compared with II group (P(12 h) < 0.05). The ascites volume, contents of inflammatory mediators in blood and pathological severity score of pancreas of III and IV group declined at different degrees compared to II group (P < 0.05, P < 0.01 or P < 0.001). Apoptotic index in III group was significantly higher than that in II group at 3 and 6 h (P(3, 6 h) < 0.05). Apoptotic index in IV group was significantly higher than that in II group at pancreatic tail at 6 h (P(6 h) < 0.05). Expression level of Bax in III group was significantly higher than that in II group (pancreatic head P(3 h,6 h) < 0.01, pancreatic tail P(3 h) < 0.001).

CONCLUSIONS

Compared with Octreotide in the treatment of SAP, the protective mechanisms of Baicalin include reducing the excessive inflammatory mediators' release, inducing the pancreatic acinar cells apoptosis.