Inosine reduces microcirculatory disturbance and inflammatory organ damage in experimental acute pancreatitis in rats

Schneider, Lutz; Pietschmann, Matthias; Hartwig, Werner; Sevillano Marcos, Sara; Hackert, Thilo; Gebhard, Martha-Maria; Uhl, Waldemar; Büchler, Markus W.; Werner, Jens

doi:10.1016/j.amjsurg.2005.09.009

« Previous Next »The American Journal of Surgery
Volume 191, Issue 4 , Pages 510-514, April 2006

Inosine reduces microcirculatory disturbance and inflammatory organ damage in experimental acute pancreatitis in rats

Lutz Schneider, M.D.
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
Matthias Pietschmann, M.D.
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
Werner Hartwig, M.D.
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
Sara Sevillano Marcos
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
Thilo Hackert, M.D.
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
Martha-Maria Gebhard, M.D.
- Department of Experimental Surgery, University of Heidelberg, Heidelberg, Germany
Waldemar Uhl, M.D.
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
Markus W. Büchler, M.D.
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
Jens Werner, M.D.
- Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany
- Corresponding author. Tel: +49-6221-5639692; fax: +49-6221-566922

Received 28 April 2005; received in revised form 27 September 2005

Abstract

Background

Despite improvement in the management of severe necrotizting pancreatitis, mortality remains high. Today, no specific treatment exists. Inflammatory cascades and microcirculatory disturbances play a key role in the pathogenesis of acute pancreatitis. The aim of the present study was to evaluate the effects of inosine, an immunomodulatory substance, on the severity of experimental necrotizing pancreatitis.

Methods

Severe necrotizing pancreatitis was induced in rats. Treatment groups received inosine either prophylactically or therapeutically. Pancreatic injury was evaluated by microcirculatory assessment and histology.

Results

Prophylactic inosine significantly attenuated pancreatic microcirculatory disturbances and morphologic injury in necrotizing pancreatitis. However, inosine treatment did not have any beneficial effects when applied therapeutically several hours after onset of the disease.

Conclusions

Prophylactic inosine reduces microcirculatory and pancreatic injury in acute necrotizing pancreatitis. These effects should be assessed in the clinical setting of ERCP and pancreas transplantation.

Keywords: Acute pancreatitis , Treatment , Microcirculation , Inosine