Local and Systemic Effects of Hypertonic Solution (NaCl 7.5%) in Experimental Acute Pancreatitis

Abstract

The administration of hypertonic saline solution in experimental AP attenuated hemodynamic alterations, decreased inflammatory cytokines, diminished systemic lesions and pancreatic acinar necrosis, prevented pancreatic infection, and reduced the mortality rate.

Do the Effects of Pentoxifylline on the Inflammatory Process and Pancreatic Infection Justify Its Use in Acute Pancreatitis?

“…In a previous study we have demonstrated that reduction of IL-6 and IL-10 production by inhibition of PGE 2 , without reduction of TNF-␣ level, did not influence the severity of AP [18] . We have also shown that administration of hypertonic saline solution attenuates the inflammatory response, reduces the hemodynamic alterations, the pancreatic infection and the mortality rate in an experimental model of acute pancreatitis [17] .…”

“…Injection flow was 0.2 ml/min. Previous studies in our laboratory with this model have shown a mortality rate of 35% after 72 h [17,18] . In the sham group, sodium taurocholate injection was omitted, but the surgical procedure was identical to the other groups, including bile duct cannulation.…”

Role of Peritoneal Macrophages on Local and Systemic Inflammatory Response in Acute Pancreatitis

“…3,16 Administration of agents that antagonize or diminish the production of TNF-is associated with decreasing of the systemic effects of acute pancreatitis. 17,18 In a previous study we have showed that treatment of rats with acute pancreatitis by administration of hypertonic saline solution reduces the production of inflammation markers (inducible nitric oxide synthase, cyclooxygenase 2, TNF-, and IL-6) in pancreatic tissue. The volume of ascitic fluid and level of cytokines in ascitic fluid were also reduced, decreasing the systemic inflammatory response in experimental acute pancreatitis.…”

Efeito da solução salina hipertônica nas lesões resultantes da isquemia/reperfusão hepática: estudo experimental em ratos

“…Diversos mediadores antiinflamatórios foram identificados; entre eles destacam-se as interleucinas IL-6 e IL-10 que, 28,42,45,92,93 Trabalhos anteriores realizados no LIM-37 da FMUSP mostraram que a solução salina hipertônica é capaz de reduzir a produção de IL-6 e IL-10 nos animais com pancreatite aguda. 64 Esses dados sugerem que o mecanismo de liberação de IL-6 e IL-10 nas síndromes inflamatórias sistêmicas (pancreatite aguda) seja diferente do mecanismo que ocorre na isquemia/reperfusão hepática, em que existe lesão direta (isquêmica) de importante contingente de macrófagos hepáticos (células de Kupffer).…”

“…52,53,56,57,63 Adicionalmente, um trabalho recente, realizado no LIM-37 da FMUSP, demonstrou que a administração de solução hipertônica melhora as medidas hemodinâmicas e reduz as citocinas inflamatórias, as lesões sistêmicas, a infecção e a necrose acinar pancreática, resultando na queda significativa da taxa de mortalidade na pancreatite aguda experimental. 64 A presença de alterações hemodinâmicas e a liberação de citocinas inflamatórias, que provocam tanto lesões locais como sistêmicas, sugerem que, no transplante de fígado, a administração de solução salina hipertônica possa ser útil na redução dessas alterações.…”