| Objectives:Severe acute pancreatitis (SAP) is an acute abdominal inflammatory disease with rapid progression, multiple complication and high mortality. It is due to that the breakdown of intestinal mucosa via accelerated apoptosis increases intestinal permeability, which can further cause the translocation of enteric bacteria, start the systemic inflammatory response syndrome, and cause multiple organ dysfunction syndrome or even multiple organ function failure. This experiment aims to investigate whether the combination of growth hormone (GH) and somatostatin (SS) can decrease intestinal mucosal cellular apoptosis on a rabbit model of SAP.Methods:A total of52rabbits were injected with5%sodium taurocholate into the pancreatic duct to set up a model of SAP, of which47were successfully induced the occurrence of SAP. In the subsequent experiments, these47rabbits were randomly divided into four groups:group A without any treatment, group B with single treatment of SS (Stilamin), group C with single treatment of GH (Saizen) and group D with treatment of GH combined with SS. For group B, Stilamin was injected at a total dose of3.5μg· kg-1·h-1one hour after the model were established for48h. For group C, Saizen was subcutaneously injected at a dose of0.15IU/kg at the time points of the1sth and24th h. For group D, GH combined with SS was applied as the above doses. The levels of D-lactate in plasma, and (Insulin like growth factor-1) IGF-1, prealbumin and albumin in serum were detected at the time points of the6th h,12th h,24th h,48th h and72nd h after modeling. The pathological changes of intestinal mucosa in terms of the villus height, crypt depth, and mucosal thickness were observed. The caspase-3expression and apoptotic indices in three groups were evaluated.Results:1. The level of plasma D-lactateThe level of D-lactate in groups C and D were significantly lower than that in other two groups at the time point of the48th h (P<0.05).2. The levels of serum IGF-1, prealbumin, and albuminThe levels of IGF-1at the time points of the24th h and48th h in groups C and D were significantly higher than that in other two groups (P<0.05). The levels of prealbumin at the time points of the24th h,48th h in groups C and D were significantly higher than that in other two groups (P<0.01), the level of prealbumin at72nd h in group D was significantly higher than that in other groups (P<0.01). The level of albumin at the time point of the48th h in groups C and D were significantly higher than that in other two groups (P<0.05).3. Pathological changes of intestinal mucosaThe structure of intestinal mucosa in group A appeared irregular and had multiple infiltration of inflammatory cells. The villi, which were oedematous and stubby, arranged in disorder or even fell off. In group B, there were less inflammatory cells and part of the villi appearing edema and ecclasis. Pathological changes in groups C and D were slighter than that in group B, the villi arranged trimly and the morphology of intestinal mucosa was integrity. The villus height, crypt depth and mucosal thickness in groups C and D significantly increased in comparison to these in group A (P<0.01) and group B (P<0.05).4. Levels of caspase-3expressionIntestinal mucosa caspase-3protein positive staining was mainly located in the cytoplasm of intestinal mucosa epithelial cells. The expression level of caspase-3in groups A and B increased more markedly than that in groups C and D (P<0.05).5. Apoptotic indicesApoptosis was mainly seen in the intestinal mucosa epithelial cells. Few apoptotic cells were seen in the propria layer. The positive cells stained by TUNEL assay had brown cellular nuclei with blue cellular plasm. The apoptotic index increased markedly in groups A and B than that in groups C and D (P<0.05).Conclusions:Intestine barrier function destroyed seriously when SAP occurred. The combination of GH and SS can decrease the apoptosis of intestinal mucosa cells and enhance intestinal mucosa barrier function of SAP. |
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