title: Nitric oxide synthase inhibition reduces albumin induced lung damage in acute pancreatitis.
abstract: OBJECTIVE
  Colloid resuscitation in acute pancreatitis (AP) is a matter of controversy due to the possible deleterious effect on lung function. A previous study demonstrates that albumin administration increases lung damage in burns and this effect can be reversed by inducible nitric oxide synthase (iNOS) inhibition. This study evaluates the effects of S-methylisothiourea (SMT), a specific iNOS inhibitor, on lungs and pancreas of rats with AP receiving intravenous albumin.
  
  
  METHODS
  AP was induced in Wistar rats by intraductal 5% taurocholate injection. To evaluate the effect of albumin on lung damage, animals received IV saline or human albumin immediately after AP (Groups: Saline and Albumin). To evaluate the effect of iNOS inhibition on lung damage, SMT was given immediately after AP (Group Saline+SMT, and Group Albumin+SMT). At 12 h after AP induction, serum amylase activity, lung vascular permeability and myeloperoxidase (MPO) activity were evaluated. Lung and pancreas histological analysis were performed.
  
  
  RESULTS
  Serum amylase activity, pancreatic edema, lung vascular permeability, MPO activity, and inflammatory infiltration were significantly increased after AP. Albumin administration increased lung vascular permeability, inflammatory infiltration, and pancreatic edema compared to saline administration (p < 0.05). Albumin administration with SMT reduced lung vascular permeability, MPO activity, and inflammatory infiltration compared to albumin administration alone (p < 0.05).
  
  
  CONCLUSIONS
  Lung and pancreatic damage induced by albumin administration for restoration of plasma volume in AP are reduced by iNOS inhibition. Awareness of this fact may be useful in high-risk patients who need to receive albumin for volume replacement.
authors.affiliation: Department of Gastroenterology (LIM/37), Medical School, University of São Paulo, São Paulo, Brazil.
authors.forename: Emilio Elias
authors.initials: EE
authors.lastname: Abdo
authors.forename: Ana Maria Mendonça
authors.initials: AM
authors.lastname: Coelho
authors.forename: Rosely Antunes
authors.initials: RA
authors.lastname: Patzina
authors.forename: Sandra Nassa
authors.initials: SN
authors.lastname: Sampietre
authors.forename: José Eduardo Monteiro
authors.initials: JE
authors.lastname: Cunha
authors.forename: Marcel Cerqueira Cesar
authors.initials: MC
authors.lastname: Machado
authors.forename: Luiz Augusto Carneiro
authors.initials: LA
authors.lastname: D'Albuquerque
mesh_terms: D000418:Albumins / Q000009:adverse effects*; D000681:Amylases / Q000097:blood / Q000187:drug effects*; D000818:Animals; D002199:Capillary Permeability / Q000187:drug effects; D007550:Isothiuronium / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008168:Lung / Q000187:drug effects* / Q000473:pathology; D052247:Nitric Oxide Synthase Type II / Q000037:antagonists & inhibitors*; D010195:Pancreatitis / Q000139:chemically induced / Q000188:drug therapy / Q000503:physiopathology*; D009195:Peroxidase; D051381:Rats; D017208:Rats, Wistar; D013656:Taurocholic Acid
chemical_list: D000418:Albumins; D007550:Isothiuronium; D013656:Taurocholic Acid; D009195:Peroxidase; D052247:Nitric Oxide Synthase Type II; C496318:Nos2 protein, rat; D000681:Amylases; C027744:S-methylisothiopseudouronium