Research Progress On Tetramethylpyrazine In Acute Pancreatitis-associated Lung Injury

Background: So far, acute pancreatitis (AP) is a common disease inwhich the pancreas becomes inflamed locally by multiple causes thatactivate pancreatic enzymes. Severe acute pancreatitis (SAP) causing lunginjury is the most common early manifestation and an extrapancreaticcommon complication. Its pathogenesis, due to the complexity, involves inmany associated influencing factors which influence each other. Numerousstudies have showed that tetramethylpyrazine (TMP) confers significanteffects on vasodilatation, inhibition of thrombosis, free radical scavengingand improvment of microcirculation. TMPZ is often used in protecting thecardiac function, lowering pulmonary hypertension, relieving renal damageand such diseases as encephalorrhagia, vascular dementia and diabetes.Numerous studies have demonstrated its protective effect on lung.Objective: To present the pathological characteristics and pathoge-nesis of acute pancreatitis-associated lung injury (APALI); to elaborate the mechanism of TMP in APALI; to investigate the experiment and clinical effect of TMP in acute lung injury (ALI) to further understand the treatment of APALI with TMP.Methods: Research literature retrieval was conducted on TMP in thetreatment of APALI with such keywords as “acute pancreatitis; acute lunginjury; tetramethylpyrazine”.Conclusion: TMP is one of the most important alkaloid componentsseparated from the rhizome of Ligusticum wallichii, a traditional Chinese medical herb. Numerous studies have demonstrated the protective effect ofTMP on lung. TMP confers significant effects on inhibiting thepathogenesis APALI, relieving the AP-evoked inflammatory response,improving the pulmonary microcirculation disturbance and protectingagainst the pulmonary morphologic and functional changes by suppressingnuclear factor-κB (NF-κB) and inhibiting the aggregation ofintrapulmonary polymorphonuclear cells, the release of inflammatorymediators and the generation of vascular endothelial growth factor (VEGF).ALI is a major cause of death for SAP, which is linked closely with theprognosis of SAP. Therefore, based on ALI, in-depth exploration of thepathogenesis and prophylaxis of post-ASP lung injury can not merelyimprove the prognosis of SAP, but offer a new direction for prophylaxisand treatment of ALI caused by multiple causes.