Role of pancreatic enzymes in gut injury secondary to trauma/hemorrhagic shock in rats

Abstract

Abstract: Objective To test the hypothesis that pancreatic digestive enzymes are involved in trauma/hemorrhagic shock (T/HS)-induced intestinal injury.Methods Male Sprague-Dawley rats were given pancreatic enzyme inhibitor (6-amidino-2 -naphthyl p-guanidinobenzoate dimethanesulfonate,ANGD) intraluminally or intravenously after laparotomy (trauma),and then subjected to 90 min of hemorrhagic shock or sham shock. Intestinal injury was assessed 3 h after resuscitation with Ringer’s lactate solution. Results Histological analysis demonstrated fewer injured villi in shock rats with intraluminal ANGD treatment than in those with intravenous ANGD administration and control shock rats. Furthermore,intestinal intraluminal perfusion of Ringer’s lactate solution without ANGD produced a certain degree of protection against T/HS-induced intestinal injury,as compared with the rats without perfusion.Conclusion Pancreatic proteolytic enzymes in ischemic gut may serve as important toxic factors contributing to gut injury following T/HS.

CLC Number:

SHI Han-ping, WEN Ying, ZHANG Ce, XUE Qi, LEI Shang-tong. Role of pancreatic enzymes in gut injury secondary to trauma/hemorrhagic shock in rats[J]. Journal of Southern Medical University, 2004, 24(10): 1137-1139.

References

[1] Deitch EA.Multiple organ failure:Pathophysiology and potential future therapy[J].Ann Surg,1992,216(2):117-34.
[2] Kistler EB,Hugli TE,Schmid-schonbein GW.The pancreas as a source of cardiovascular cell activating factors [J].Microcirculation,2000,7(3):183-92.
[3] Kyogoku T,Manabe T,Tobe T.Role ofischemia in acute pancreatitis.Hemorrhagic shock converts edematous pancreatitis to hemorrhagic pancreatitis in rats [J].Dig Dis Sci,1992,37(9):1409-17.
[4] Sakorafas GH,Tsiotos GG,Sarr MG.Ischemia/reperfusion-induced pancreatitis [J].Dig Surg,2000,17(1):3-14.
[5] Ramachandran A,Balasubramanian KA.Protease activation during surgical stress in rat small intestine [J].J Surg Res,2000,92(2):283-90.
[6] Lefer AM,Spath JA Jr.Pancreatic hypoperfusion and the production of a myocardial depressant factor in hemorrhagic shock [J].Ann Surg,1974,179(6):868-76.
[7] Montgomery A,Borgstrom A,Haglund U.Pancreatic proteases and intestinal mucosal injury after ischemia and reperfusion in the pig[J].Gastroenterology,1992,102(1):216-22.
[8] Aoyama T,Ino Y,Ozeki M,et al.Pharmacological studies of FUT-175,nafamstat mesilate.I.Inhibition of protease activity in in vitro and in vivo experiment[J].Jpn J Pharmacol,1984,35(3):203-27.
[9] Schmid-Schonbein GW,Kistler EB,Hugli TE.Mechanisms for cell activation and its consequences for biorheology and microcir:culation:Multi-organ failure in shock [J].Biorheology,2001,38(2-3):185-201.
[10] Shi HP,Deitch EA,Xu DZ,et al.Hypertonic saline improves intestinal mucosa barrier function and lung injury after traumahemorrhagic shock[J].Shock,2002,17(6):496-501.
[11] Lefer AM,Glenn TM.Role of the pancreas in the pathogenesis of circulatory shock[J].Adv Exp Med Biol,1971,23:311-35.
[12] Glenn TM,Herlihy BL,Ferguson WW,et al.Protective effect of pancreatic duct ligation in splanchnic ischemia shock [J].Am J Physiol,1972,222(5):1278-84.
[13] Jones RT,Garcia JH,Mergner WJ,et al.Effects of shock on the pancreatic acinar cell.Cellular and subcellular effects in humans [J].Arch Pathol,1975,99(12):634-44.
[14] Bounous G,Brown RA,Mulder DS,et al.Abolition of ＂tryptic enteritis＂ in the shocked dog[J].Arch Surg,1965,91:371-5.
[15] Deitch EA,Shi HP,Lu Q,et al.Serine proteases are involved in the pathogenesis of trauma-hemorrhagic shock-induced gut and lung injury[J].Shock,2003,19(5):452-6.