Published online Jan 7, 2020. doi: 10.3748/wjg.v26.i1.35
Peer-review started: September 26, 2019
First decision: November 4, 2019
Revised: December 6, 2019
Accepted: December 13, 2019
Article in press: December 13, 2019
Published online: January 7, 2020
Processing time: 103 Days and 4.5 Hours
Abdominal paracentesis drainage (APD) is a safe and effective strategy for severe acute pancreatitis (SAP) patients. However, the effects of APD treatment on SAP-associated cardiac injury remain unknown.
To investigate the protective effects of APD on SAP-associated cardiac injury and the underlying mechanisms.
SAP was induced by 5% sodium taurocholate retrograde injection in Sprague-Dawley rats. APD was performed by inserting a drainage tube with a vacuum ball into the lower right abdomen of the rats immediately after SAP induction. Morphological staining, serum amylase and inflammatory mediators, serum and ascites high mobility group box (HMGB) 1, cardiac-related enzymes indexes and cardiac function, oxidative stress markers and apoptosis and associated proteins were assessed in the myocardium in SAP rats. Nicotinamide adenine dinucleotide phosphate oxidase activity and mRNA and protein expression were also examined.
APD treatment improved cardiac morphological changes, inhibited cardiac dysfunction, decreased cardiac enzymes and reduced cardiomyocyte apoptosis, proapoptotic Bax and cleaved caspase-3 protein levels. APD significantly decreased serum levels of HMGB1, inhibited nicotinamide adenine dinucleotide phosphate oxidase expression and ultimately alleviated cardiac oxidative injury. Furthermore, the activation of cardiac nicotinamide adenine dinucleotide phosphate oxidase by pancreatitis-associated ascitic fluid intraperitoneal injection was effectively inhibited by adding anti-HMGB1 neutralizing antibody in rats with mild acute pancreatitis.
APD treatment could exert cardioprotective effects on SAP-associated cardiac injury through suppressing HMGB1-mediated oxidative stress, which may be a novel mechanism behind the effectiveness of APD on SAP.
Core tip: In the present study, we provided the first evidence that abdominal paracentesis drainage (APD) treatment exerts beneficial effects on severe acute pancreatitis-associated cardiac injury. Our key findings are that (1) APD treatment decreases the serum levels of cardiac enzymes and improves cardiac function; (2) APD treatment alleviates cardiac oxidative stress and accompanied cardiomyocyte apoptosis; and (3) The beneficial effects of APD treatment in ameliorating severe acute pancreatitis-associated cardiac injury are due to the inhibition of oxidative damage via downregulating high mobility group box 1-mediated nicotinamide adenine dinucleotide phosphate oxidase expression. Our data manifest that APD is a promising treatment in severe acute pancreatitis-associated cardiac injury.