The Role Of GM-CSF In Acute Necrosis Pancreatitis Associated Acute Lung Injury And The Treatment With Drug

Objitive: Acute Lung injury (ALI) manifesting clinically as acute respiratory distress syndrom (ARDS) is a common cause of morbidity and mortality following acute necrosis pancreatitis (ANP).Neutrophils play a critical role in the progression of ANP to ARDS. Granulocyte-macrophage colony stimulating factor (GM-CSF) is a cytokine which has shown to induce 1) an increased neutrophil count,2) neutrophil actication,3)neutrophil degrannulation ,and 4) the release of IL-8 as well as MIP-2 .both cytokines known to play a key role in acute lung injury .but the role of GM-CSF in ANP associated lung injury in rats is not known .we aimed at studying the role of GM-CSF in lung and evaluating the effect of "YiYanHeJi"during the experiment. Methods: Acute necrosis pancreatitis combined with acute lung injury model was induced by retrograde injection of 5% sodium taurocholate in biliopancreatic duct in rats. 120 healthy wistar rats, weight 200g-250g, randomly divided into 4 group: model group, YiYanHeJi-treated group, Ulinastatin (UTI)-treated group and negative group , with 30 rats in each group. severity of ANP was determined by quantitating plasma amylase activity , and observing pancreatic tissue with light microscope. severity of pancreatitis-associated lung injury was evaluated by quantitating lung water content, lung myeloperoxidase (MPO) activity and observing lung tissue with light microscope. the change of GM-CSF level in lung tissue was determined by enzyme-linked immunosorbent assay (ELISA). analyze the data with statistic software SPSS12.0 . Result: the pathological section manifest that the experimental model of acute necrosis pancreatitis combined with acute lung injury was successfully induced in each subgroup after 5% sodium taurocholate injected in the biliopancreatic duct. the levels of GM-CSF in lung are significantly elevated in model group compared with the other groups (p<0.01), and reach to its peak at 12-24 hours. the levels of MPO and W/D in lung are significantly elevated also compared with the other groups (p<0.01), and reach to its peak at 24 hours. the levels of GM-CSF , MPO and W/D are similar in YiYanHeJi-treated group and Ulinastatin (UTI)-treated group except 6h subgroup (p>0.05). the lung levels of GM-CSF and that of MPO and W/D are correlated positively. (respectively r = 0.6661 ,p<0.01 ; r = 0.7668 ,p<0.01), and the lung levels of MPO and W/D are also positively correlated (r =0.5706 ,p< 0.01) . Conclusion: the methods of retrograde injected 5% sodium taurocholate in the biliopancreatic duct to induce acute necrosis...