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. 2007 Oct;88(5):343-9.
doi: 10.1111/j.1365-2613.2007.00538.x.

Extrapancreatic organ impairment during acute pancreatitis induced by bile-pancreatic duct obstruction. Effect of N-acetylcysteine

Manuel A Manso  1 , Laura Ramudo, Isabel De Dios
Affiliations

Extrapancreatic organ impairment during acute pancreatitis induced by bile-pancreatic duct obstruction. Effect of N-acetylcysteine

Manuel A Manso et al. Int J Exp Pathol. 2007 Oct.

Abstract

Multiple organ failure is frequently associated with acute pancreatitis (AP). Our aim was to study pulmonary, hepatic and renal complications developed in the course of AP experimentally induced in rats by bile-pancreatic duct obstruction (BPDO), differentiating the complications caused by AP itself, from those directly caused by bile duct obstruction (BDO), after ligating the choledocus. N-acetylcysteine (NAC) was administered as a therapeutic approach. Myeloperoxidase activity revealed neutrophil infiltration in lungs from 12 h after BDO, even if AP was not triggered. Lactate dehydrogenase (LDH) activity indicated hepatocyte death from 48 h after BDO, and from 24 h following BPDO-induced AP onwards, an effect delayed until 48 h by NAC treatment. Rats with single cholestasis (BDO) and rats with BPDO-induced AP showed a significant increase in plasma aspartate aminotransferase (AST), alanine aminotransferase (ALT) and bilirubin concentration from 12 h onwards, whose values were reduced by NAC treatment at early BPDO. No renal failure was found during 120 h of bile-pancreatic obstruction. Our results showed lung and liver impairment as a result of BDO, even if AP does not develop. Pancreatic damage and extrapancreatic complications during AP induced by BPDO were palliated by NAC treatment.

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Figures

Figure 1
Figure 1
Plasma amylase activity in sham-operated animals, rats with bile duct obstruction (BDO), rats with acute pancreatitis induced by bile-pancreatic duct obstruction (BPDO) and rats with BPDO treated with NAC (NAC-BPDO). Number of animals in each group and experimental period: 6. Values are mean ± SEM. anova followed by Scheffé test showed statistically significant differences vs. sham-operated (*), vs. BDO rats (♦) and between NAC-treated and non-treated BPDO rats.
Figure 2
Figure 2
Tissue water content in pancreas (a), lung (b) and liver (c) from sham-operated animals, rats with bile duct obstruction (BDO), rats with acute pancreatitis induced by bile-pancreatic duct obstruction (BPDO) and rats with BPDO treated with NAC (NAC-BPDO). Number of animals in each group and experimental period: 6. Values are mean ± SEM. anova followed by Scheffé test showed statistically significant differences in pancreas vs. sham-operated (*) and vs. BDO rats (♦). No significant difference was found in the lung. Significant differences vs. sham-operated (*) were found in liver.
Figure 3
Figure 3
Myeloperoxidase (MPO) activity in pancreas (a) lung (b) and liver (c) from sham-operated animals, rats with bile duct obstruction (BDO), rats with acute pancreatitis induced by bile-pancreatic duct obstruction (BPDO) and rats with BPDO treated with NAC (NAC-BPDO). Number of animals in each group and experimental period: 6. Values are mean ± SEM. anova followed by Scheffé test showed statistically significant differences in pancreas and lung vs. sham-operated (*), vs. BDO rats (♦) and between NAC-treated and non-treated BPDO rats. No differences were found in liver.
Figure 4
Figure 4
Lactate dehydrogenase (LDH) activity in liver from sham-operated animals, rats with bile duct obstruction (BDO), rats with acute pancreatitis induced by bile-pancreatic duct obstruction (BPDO) and rats with BPDO treated with NAC (NAC-BPDO). Number of animals in each group and experimental period: 6. Values are mean ± SEM. anova followed by Scheffé test showed statistically significant differences vs. sham-operated (*) and between NAC-treated and non-treated BPDO rats.
Figure 5
Figure 5
Plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST) and bilirubin concentration in sham-operated animals, rats with bile duct obstruction (BDO), rats with acute pancreatitis induced by bile-pancreatic duct obstruction (BPDO) and rats with BPDO treated with NAC (NAC-BPDO). Number of animals in each group and experimental period: 6. Values are mean ± SEM. anova followed by Scheffé test showed showed statistically significant differences vs. sham-operated (*), vs. BDO rats (♦) and between NAC-treated and non-treated BPDO rats.
Figure 6
Figure 6
Plasma creatinine in sham-operated animals, rats with bile duct obstruction (BDO), rats with acute pancreatitis induced by bile-pancreatic duct obstruction (BPDO) and rats with BPDO treated with NAC (NAC-BPDO). Number of animals in each group and experimental period: 6. Values are mean ± SEM. anova followed by Scheffé test did not show any significant difference among groups.
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