Hydrocortisone treatment of early SIRS in acute experimental pancreatitis.
This work studied the effects of hydrocortisone treatment in experimental acute pancreatitis on cytokines, phospholipase A2, and breakdown products of arachidonic acid and survival. Edematous and necrotizing pancreatitis were induced in Wistar rats by cerulein hyperstimulation and retrograde intraductal infusion of sodium taurocholate, respectively. Hydrocortisone (10 mg/kg) was administered intravenously 10 minutes after induction of acute pancreatitis. Serum was assayed for phospholipase A2; interleukin (IL) 1beta, IL-6, IL-10, thromboxane B2; Prostaglandin E2; and leukotriene B4 at five different time points. A significant release of inflammatory mediators was seen only in the severe model. Hydrocortisone powerfully suppressed arachidonic acid breakdown products and only mildly attenuated the systemic increase of phospholipase A2 and pro- and antiinflammatory cytokines. The mortality rate after 72 hr in the severe model was 86%. Hydrocortisone treatment reduced mortality to 13% (P = 0.001; Fisher's exact test). Hydrocortisone seems to be effective in the treatment of the early systemic inflammatory response syndrome associated with severe acute pancreatitis.
Gloor
B
B
Department of Visceral and Transplantation Surgery, University Hospital of Bern, Switzerland.
Uhl
W
W
Tcholakov
O
O
Roggo
A
A
Muller
C A
CA
Worni
M
M
Büchler
M W
MW
D000208:Acute Disease; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D016207:Cytokines / Q000378:metabolism; D015232:Dinoprostone / Q000097:blood; D004195:Disease Models, Animal; D005260:Female; D006854:Hydrocortisone / Q000627:therapeutic use*; D007975:Leukotriene B4 / Q000097:blood; D010195:Pancreatitis / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D051381:Rats; D017208:Rats, Wistar; D018746:Systemic Inflammatory Response Syndrome / Q000188:drug therapy* / Q000209:etiology; D013929:Thromboxane B2 / Q000097:blood
D000893:Anti-Inflammatory Agents; D016207:Cytokines; D007975:Leukotriene B4; D013929:Thromboxane B2; D015232:Dinoprostone; D006854:Hydrocortisone