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Further evidence for endothelin as an important mediator of pancreatic and intestinal ischemia in severe acute pancreatitis.
- Source :
-
Pancreas [Pancreas] 2003 Apr; Vol. 26 (3), pp. 218-23. - Publication Year :
- 2003
-
Abstract
- Introduction: Severe acute pancreatitis is occasionally associated with pancreatic and intestinal necrosis. Mesenteric vasoconstriction is one of the most probable types of pathogenesis of these complications.<br />Aim: To investigate the involvement of endothelin-1 (ET-1), a potent vasoconstrictor.<br />Methodology and Results: Plasma ET-1 concentrations were extremely high in patients with pancreatic and/or diffuse intestinal necrosis. ET-1 mRNA was demonstrated in the rat pancreas, and the production of ET-1 protein by human umbilical vein endothelial cells was enhanced by tumor necrosis factor-alpha, thrombin, and protease-activated receptor-2-activating peptide. Administration of ET-1 in vivo induced mesenteric arterial spasm and decreased pancreatic and intestinal blood flow.<br />Conclusion: These results suggest the following: ET-1 is produced in and around the pancreas, mainly by endothelial cells, in severe acute pancreatitis; in the inflammatory setting, cytokines, activated thrombin and trypsin, may stimulate ET-1 production in a paracrine fashion; produced ET-1 may exaggerate the splanchnic microcirculation; and progressive ischemia may lead to necrosis of the pancreas and intestine.
- Subjects :
- Acute Disease
Adolescent
Adult
Aged
Animals
Endothelin-1 blood
Endothelin-1 genetics
Female
Humans
Intestines pathology
Male
Mesenteric Arteries pathology
Mesenteric Arteries physiopathology
Middle Aged
Necrosis
Pancreas pathology
Pancreatitis blood
Pancreatitis diagnosis
RNA, Messenger metabolism
Rats
Rats, Wistar
Vasoconstriction
Endothelin-1 physiology
Intestines blood supply
Ischemia etiology
Pancreas blood supply
Pancreatitis complications
Subjects
Details
- Language :
- English
- ISSN :
- 1536-4828
- Volume :
- 26
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Pancreas
- Publication Type :
- Academic Journal
- Accession number :
- 12657945
- Full Text :
- https://doi.org/10.1097/00006676-200304000-00002