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Why could ethyl pyruvate attenuate severe acute pancreatitis?
October 13, 2008Excessive activation of inflammatory mediator cascade during SAP is a major cause of distant organ injury and the high mortality. Cytokines such as TNF- alpha and IL-1 beta are released early in the development of systemic inflammatory response. This leaves a narrow therapeutic window for administration of therapeutics and delayed delivery of that anti-inflammatory therapeutics is not effective after the inflammatory mediator cascade has developed.
A research article to be published on July 28, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Prof. Wang from Centre of Pancreatic Surgery of Xiehe Hospital, Tongji Medical College, Huazhong University of Sciecne and Technology, demonstrated that the serum levels of HMGB1 began to rise significantly at 12 h, and maintained at high levels up to 48 h after induction of experimental SAP in rats. The delayed kinetics indicated that HMGB1 may provide a broader therapeutic window for treating this lethal systemic inflammatory disease. EP was proved could inhibit HMGB1 release from macrophages and prevent the accumulation of serum HMGB1 levels in mice with lethal sepsis through inhibiting NF- kappaB and p38 MAPK signaling. The research, performed by this team, investigated whether delayed EP therapy attenuates experimental SAP via reducing serum HMGB1 levels in rats or not.
In this study, EP significantly reduced serum HMGB1 levels in rats with SAP, even though began delivering EP at 12 h after induction of SAP. It also significantly protected against liver, renal and lung injury, and prolonged survival time of rats. Ethyl pyruvate, a stable lipophilic pyruvate derivatives, is a nontoxic food additive. According to this article, EP may serve potentially as an effective and low-cost therapeutic option against the inflammatory response and MODS in SAP patients.
This report is of interest and considerable potential importance because it indicates that delayed treatment of rats with experimental severe acute pancreatitis with ethyl pyruvate is associated with a reduction of HMGB1 levels in blood; a decrease in lung, kidney, and liver injury; and prolonged survival. The "therapeutic window" for inhibiting this inflammatory mediator appears to be more favorable than for some other mediators which more rapidly reach a peak in the blood.
World Journal of Gastroenterology
This report is of interest and considerable potential importance because it indicates that delayed treatment of rats with experimental severe acute pancreatitis with ethyl pyruvate is associated with a reduction of HMGB1 levels in blood; a decrease in lung, kidney, and liver injury; and prolonged survival. The "therapeutic window" for inhibiting this inflammatory mediator appears to be more favorable than for some other mediators which more rapidly reach a peak in the blood.
World Journal of Gastroenterology
Acute Pancreatitis Current Events and Acute Pancreatitis News RSSA case of post-gastrectomy acute pancreatitis
Gastrectomy is commonly performed for both benign and malignant lesions. Although the incidence of post-gastrectomy acute pancreatitis (PGAP) is low compared to other well-recognized post-operative complications, it has been reported to be associated with a high mortality rate.
Genetically engineered mice don't get obese, but do develop gallstones
Obesity and gallstones often go hand in hand. But not in mice developed at Washington University School of Medicine in St. Louis. Even when these mice eat high-fat diets, they don't get fat, but they do develop gallstones.
Should intra-abdominal pressure measurement be a routine for all pancreatitis patients?
Acute pancreatitis remains a disease with an unpredictable clinical course, and significant associated morbidity and mortality. Recently, the elevated intraabdominal pressure (IAP) after onset of acute pancreatitis has gained growing attention, because it is increasingly recognized as an important risk factor for mortality in the early phase of the disease.
Arterial infusion using gabexate mesilate: Is it effective therapy for severe acute pancreatitis?
Severe acute pancreatitis (SAP) remains a lethal disease. It is defined as an inflammatory process of the pancreas with possible peripancreatic tissue and multi-organ involvement inducing multi-organ dysfunction syndrome (MODS) with an increased mortality rate.
Arterial infusion using gabexate mesilate: Is it effective therapy for severe acute pancreatitis?
Severe acute pancreatitis (SAP) remains a lethal disease. It is defined as an inflammatory process of the pancreas with possible peripancreatic tissue and multi-organ involvement inducing multi-organ dysfunction syndrome (MODS) with an increased mortality rate.
UIC researchers hunting drugs for devastating parasitic disease
Hundreds of millions of people, mainly in developing countries, are disabled by infectious diseases, according to the World Health Organization.
Early surgical treatment contributes to better outcomes in gallstone pancreatitis cases
Although delaying surgical treatment remains the standard of care for patients with severe gallstone pancreatitis, a new study published in the December issue of the Journal of the American College of Surgeons shows that, contrary to widespread belief, early cholecystectomy -- or surgical removal of the gallbladder -- significantly reduces hospital stays in patients with mild to moderate gallstone pancreatitis with no increase in complications or mortality.
Large dose dexamethasone plays important roles in severe acute pancreatitis
Severe acute pancreatitis (SAP) is a fatal systemic disease featuring acute onset, serious conditions, high incidence of complications and 20 - 30% mortality, mainly due to multiple organ failure at its early stage.
Acute pancreatitis and cholangitis: a complication caused by a migrated gastrostomy tube
Percutaneous endoscopic gastrostomy (PEG) is generally considered to be safe with a low rate of serious complications. However, dislocation of a gastrostomy tube can lead to serious complications.
Short-term hemofiltration is cost-effective for severe acute pancreatitis
Early nasogastric enteral nutrition is a breakthrough in the management of severe acute pancreatitis. From meta-analysis based on current available clinical studies early nasogastric enteral nutrition appeared effective and safe in clinical practice.
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