The effect of erythropoietin to pulmonary injury and mast cells secondary to acute pancreatitis

Abstract

Background: Acute pancreatitis is a life-threatening necroinflammatory disease that is characterized by systemic inflammatory response syndrome and acute lung injury even in its very first days. Erythropoietin (EPO) is a hormone considered as an antiapoptotic and cytoprotective with observed receptors of anti-inflammatory effect on organs apart from the liver and the kidneys. In this study, the effects of EPO on pulmonary mast cells and on secondary injury caused by acute pancreatitis are investigated.

Methods: Twenty one Wistar Albino rats were divided into three groups--sham, control, and EPO groups-with 7 rats per group. Pancreatitis was induced by administering 4.5% sodium taurocholate into the pancreatic duct. A 1000 U/kg/day dosage (three times) of EPO was administered to the EPO group. Blood urea nitrogen (BUN), creatinine, amylase, and troponin I in the serum were studied; and lung, kidney, brain, and heart tissues were examined histopathologically.

Results: There were no histopathological changes in the other organ tissues except for the lung tissue. Compared to the control group, the EPO group showed significantly reduced alveolar hemorrhage, septal neutrophil infiltration, lung wall thickness score, and mast cell count in the lung tissue.

Conclusions: Administration of EPO reduces the mast cell count and lung wall thickness, and it reduces the alveolar hemorrhage and septal infiltration induced by acute pancreatitis.

Figure 1

Histologic changes in the control group: (a) Extensive hemorrhage in lung parenchyma, (b) inflammatory cells neutrophil infiltration, (c) vascular proximity lymphocyte infiltration, (d) alveolar fluid (hematoxylin eosin-x40).

Figure 2

Histologic changes in the EPO and Sham groups: (a) reduced hemorrhage in the EPO group (hematoxylin eosin-x40), (b) histological appearance of the lung in the sham group(toluidine blue dye).

Figure 3

Distribution of mast cells in the groups: (a) Pronounced edema and a multitude of mast cells in vascular proximity of control group, (b) at larger magnification, the majority of mast cells are seen to be degranulated (c) decreased mast cell count and edema in EPO group (toluidine blue dye), (d) rare mast cells in the sham group (toluidine blue dye).