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Yang T, Zhao G, Zhu W, Yu W, Jiang Y, Zhou Y, Li Y. Effect on the splenocyte function of weaned piglets induced by continuous lipopolysaccharide injections. J Vet Res 2024; 68:295-302. [PMID: 38947147 PMCID: PMC11210365 DOI: 10.2478/jvetres-2024-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 04/22/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction When piglets are exposed to pathogens for a long period, the immune system organs, among them the spleen, play a major role in combating the stress caused by those pathogens. In the present study, the effect on splenocyte function was investigated in a model of weaned piglets in which stress was induced by multiple low doses of lipopolysaccharide (LPS). Material and Methods Forty-eight 28-day-old piglets were divided into two groups: the LPS group and the control group. During the experimental period of thirteen days, the LPS group was intraperitoneally injected with LPS (100 μg/kg) once per day, and the control group was injected with the same volume of 0.9% sterile saline. On the 1st, 5th, 9th and 13th days, the piglets' spleens were collected for isolating splenocytes. The proliferation ability of splenocytes was evaluated by the cell-counting-kit 8 method. Flow cytometry was used to detect cell cycle stage and apoptosis, and the nitric oxide level of cell supernatant was also tested. Results In the experimental group, the proliferation ability of splenocytes was enhanced, the proportion of cells in the G0/G1 phase was smaller, and cells were promoted to the S and G2/M phases. Meanwhile, apoptosis was suppressed and nitric oxide release upregulated. The results were significantly different between the LPS group and the control group on the 5th and 9th days. Conclusion The difference between the results of one group and those of the other suggest that after the 5th LPS injection, multiple low doses of LPS activated splenocytes and restored the number of splenocytes, which maintained and possibly enhanced the regulation of the immune function of the spleen.
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Affiliation(s)
- Tingyu Yang
- College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang330045, Jiangxi, China
| | - Guotong Zhao
- College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang330045, Jiangxi, China
| | - Wenlu Zhu
- College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang330045, Jiangxi, China
| | - Wanting Yu
- College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang330045, Jiangxi, China
| | - Yijie Jiang
- College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang330045, Jiangxi, China
| | - Yunxiao Zhou
- College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang330045, Jiangxi, China
| | - Yong Li
- College of Animal Science and Technology, Jiangxi Agricultural University, Nanchang330045, Jiangxi, China
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Wang SQ, Jiao W, Zhang J, Zhang JF, Tao YN, Jiang Q, Yu F. Ulinastatin in the treatment of severe acute pancreatitis: A single-center randomized controlled trial. World J Clin Cases 2023; 11:4601-4611. [PMID: 37469723 PMCID: PMC10353502 DOI: 10.12998/wjcc.v11.i19.4601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/16/2023] [Accepted: 06/02/2023] [Indexed: 06/30/2023] Open
Abstract
BACKGROUND Severe acute pancreatitis (AP) is one of the most common diseases of the gastrointestinal tract and carries a significant financial burden with high disability and mortality. There are no effective drugs in the clinical management of severe AP, and there is an absence of evidence-based medicine concerning the treatment of severe AP.
AIM To explore whether ulinastatin (UTI) can improve the outcome of severe AP.
METHODS The present research included patients who were hospitalized in intensive critical care units (ICUs) after being diagnosed with severe AP. Patients received UTI (400000 IU) or placebos utilizing computer-based random sequencing (in a 1:1 ratio). The primary outcome measures were 7-d mortality, clinical efficacy, inflammatory response, coagulation function, infection, liver function, renal function, and drug-related adverse effects were evaluated.
RESULTS A total of 181 individuals were classified into two groups, namely, the placebo group (n = 90) and the UTI group (n = 91). There were no statistically significant differences in baseline clinical data between the two groups. The 7-d mortality and clinical efficacy in the UTI group were remarkably improved compared with those in the placebo group. UTI can protect against hyperinflammation and improve coagulation dysfunction, infection, liver function, and renal function. UTI patients had markedly decreased hospital stays and hospitalization expenditures compared with the placebo group.
CONCLUSION The findings from the present research indicated that UTI can improve the clinical outcomes of patients with severe AP and has fewer adverse reactions.
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Affiliation(s)
- Su-Qin Wang
- Department of General Surgery, The 904th Hospital of Joint Logistic Support Force, Wuxi 214044, Jiangsu Province, China
| | - Wei Jiao
- Department of Nursing, The 904th Hospital of Joint Logistic Support Force, Wuxi 214044, Jiangsu Province, China
| | - Jing Zhang
- Department of Nursing, The 904th Hospital of Joint Logistic Support Force, Wuxi 214044, Jiangsu Province, China
| | - Ju-Fen Zhang
- Department of Neurosurgery, The 904th Hospital of Joint Logistic Support Force, Wuxi 214044, Jiangsu Province, China
| | - Yun-Na Tao
- Department of Neurosurgery, The 904th Hospital of Joint Logistic Support Force, Wuxi 214044, Jiangsu Province, China
| | - Qing Jiang
- Department of General Surgery, The 904th Hospital of Joint Logistic Support Force, Wuxi 214044, Jiangsu Province, China
| | - Feng Yu
- Department of General Surgery, The 904th Hospital of Joint Logistic Support Force, Wuxi 214044, Jiangsu Province, China
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Kim KW, Huh J, Lee SJ, Kim SP, Kim EB, Kim JC. Ulinastatin Supplementation During Human Amniotic Membrane Preservation to Improve its Viability. Curr Eye Res 2018; 43:621-629. [PMID: 29400632 DOI: 10.1080/02713683.2018.1434896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The amniotic membrane (AM) is the transparent innermost layer of the placenta and it facilitates rapid wound healing in a diversity of ocular surface disorders. However, extended periods of cryopreservation before use induce significant impairment of cell viability due to oxidative stresses and inflammatory responses. We investigated the effect of supplementing ulinastatin (ULI), a known serine protease inhibitor, and relevant mechanisms of action in AM preservation solution through the hypothermic continuum on inflammatory and apoptotic signals and viability of AM tissue. MATERIALS AND METHODS The expression of inflammatory signal factors, including high mobility group box 1 (HMGB1), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), receptor-interacting serine/threonine-protein kinase 3 (RIPK3) and anti-TNF-inducible gene 6 (TSG-6) which is a TNF-α-inducible anti-inflammatory protein, and the expression of apoptotic signal factors, including caspase (Cas)-9 and Cas-8, the initiators, and Cas-3, the executioner caspase and Bax were analyzed with or without ULI during hypothermic preservation of human AM. Subsequently, the actual viability of human AM tissue was verified with or without ULI supplementation throughout hypothermic continuum (both hypothermic- and cryopreservation). RESULTS Hypothermic AM preservation with ULI for 48 h resulted in downregulated expression of cold-inducible inflammatory factors, including HMGB1 and NF-κB, as well as RIPK3. In addition, ULI suppressed apoptotic signals related with Cas-9, Cas-8, and Cas-3 under hypothermic conditions. Furthermore, ULI supplementation during hypothermic- and cryopreservation of AM significantly enhanced viability of AM tissue and amniotic epithelial cells. CONCLUSIONS Supplementation of ULI during human AM preservation through the hypothermic continuum may be a feasible dual anti-inflammatory and anti-apoptotic strategy that enhances the viability of AM tissue.
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Affiliation(s)
- Kyoung Woo Kim
- a Graduate School of Chung-Ang University, College of Medicine , Seoul , Korea
| | - Jung Huh
- b Department of Ophthalmology , College of Medicine, Chung-Ang University Hospital , Seoul , Korea
| | - Soo Jin Lee
- b Department of Ophthalmology , College of Medicine, Chung-Ang University Hospital , Seoul , Korea
| | - Sung Po Kim
- c SK Bioland , Cheonan-si , Chungcheongnam-do , Korea
| | - Eung Bae Kim
- c SK Bioland , Cheonan-si , Chungcheongnam-do , Korea
| | - Jae Chan Kim
- b Department of Ophthalmology , College of Medicine, Chung-Ang University Hospital , Seoul , Korea
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Pan Y, Fang H, Lu F, Pan M, Chen F, Xiong P, Yao Y, Huang H. Ulinastatin ameliorates tissue damage of severe acute pancreatitis through modulating regulatory T cells. J Inflamm (Lond) 2017; 14:7. [PMID: 28344516 PMCID: PMC5360080 DOI: 10.1186/s12950-017-0154-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 03/14/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Ulinastatin or urinary trypsin inhibitor (UTI) has been shown to ameliorate the inflammatory response induced by experimental severe acute pancreatitis (SAP) and hence reduce the mortality, however the mechanism of its action remains incompletely understood. We have investigated the effect of ulinastatin on regulatory T-cells (Tregs) in an established rat model of SAP. METHODS We established a rat SAP model by injecting 5% Na-taurocholate into the pancreatic duct and treated the SAP rats with ulinastatin with different dose level (5000, 10000, 30000 U/kg) through intraperitoneal injection at 0, 6 and 12 h. RESULTS We showed that the tissue damage of pancreas and the mortality of the SAP rats were significantly reduced by ulinastatin. We also showed that in the SAP rats the frequencies of CD4+ T cells and Tregs, as well as the expressions of TGF-β1, CTLA-4, and Foxp3 were decreased in the SAP animals while IL-1β, IL-10 and TNF-α were significantly increased. Treatment with ulinastatin up-regulated the proportion of Tregs in CD4+ T cells and the expression of IL-10, Foxp3 and CTLA-4 in the SAP rats in a dose dependence fashion, while down-regulating the levels of L-1β and TNF-α, myeloperoxidase (MPO) activity. CONCLUSIONS Our findings suggest that ulinastatin alleviates inflammatory response and tissue damage in SAP rats by increasing the proportion of Tregs. Our study provides a new mechanism for the beneficial effect of ulinastatin in SAP rat model.
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Affiliation(s)
- Yu Pan
- General Surgery Department, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, 350001 People’s Republic of China
| | - Haizong Fang
- General Surgery Department, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, 350001 People’s Republic of China
| | - Fengchun Lu
- General Surgery Department, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, 350001 People’s Republic of China
| | - Minggui Pan
- Department of Oncology and Hematology, Kaiser Permanente Medical Center, 710 Lawrence Expressway, Santa Clara, CA 95051 USA
| | - Fei Chen
- General Surgery Department, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, 350001 People’s Republic of China
| | | | - Yi Yao
- General Surgery Department, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, 350001 People’s Republic of China
| | - Heguang Huang
- General Surgery Department, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, 350001 People’s Republic of China
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Sun JQ, Zhou J, Zheng RJ. Clinical efficacy of Taohe Chengqi decoction plus ulinastatin for patients with severe acute pancreatitis. Shijie Huaren Xiaohua Zazhi 2017; 25:281-286. [DOI: 10.11569/wcjd.v25.i3.281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the clinical efficacy of Taohe Chengqi decoction plus ulinastatin for patients with severe acute pancreatitis (SAP).
METHODS One hundred and twenty-four SAP patients treated at our hospital from June 2012 to June 2016 were randomly divided into either a control or an observation group (n = 62 each). The control group received ulinastatin injection alone, while the observation group was treated with Taohe Chengqi decoction plus ulinastatin injection. Serum levels of tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-10, and acute physiology and chronic health evaluation II (APACHE II) score were measured before treatment and on days 3, 7, and 14 after treatment in both groups. After treatment, clinical efficacy, symptom improvement, and complications were compared for the two groups.
RESULTS Times to the relief of abdominal pain, abdominal distention, recovery of normal bowel sounds, first flatus, and first anal defecation, and hospitalization days were significantly shorter in the observation group than in the control group (P < 0.05). Serum levels of IL-6 and TNF-α, and APACHE II scores on days 3, 7 and 14 were significantly lower, and those of IL-10 were significantly higher in the observation group than in the control group. The incidence of complications such as shock, acute respiratory distress syndrome, and acute renal failure was significantly lower in the observation group than in the control group (P < 0.05). The overall effective rate of the observation group was significantly higher than that of the control group (93.6% vs 80.6%, P < 0.05).
CONCLUSION Taohe Chengqi decoction plus ulinastatin can significantly improve serum and clinical parameters and reduce the incidence of complications in SAP patients.
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Zhang C, Wang Y, Fu W, Zhang W, Wang T, Qin H. A Meta-analysis on the Effect of Ulinastatin on Serum Levels of C-Reactive Protein, Interleukin 6, and Tumor Necrosis Factor Alpha in Asian Patients with Acute Pancreatitis. Genet Test Mol Biomarkers 2016; 20:118-124. [PMID: 26780230 DOI: 10.1089/gtmb.2015.0192] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES We aimed to investigate the influence of ulinastatin (UTI) on the serum levels of C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) in Asian patients with acute pancreatitis (AP) by performance of a meta-analysis. METHODS Two investigators independently searched 11 databases, including PUBMED, EBSCO, Ovid, SpringerLink, Wiley, Web of Science, Cochrane Library, Wanfang database, China National Knowledge Infrastructure (CNKI), Chinese Journal Full-text Database, and China Biomedicine Database. The full-text articles were screened and the data were extracted using a standardized data extraction form. All statistical analyses were conducted with Stata software, version 12.0 (Stata Corporation, College Station, TX). RESULTS A total of 94 studies were initially retrieved, and 10 studies containing 424 Asian patients with AP were ultimately enrolled in this meta-analysis. The results revealed that the serum levels of CRP, IL-6, and TNF-α in Asian AP patients significantly decreased after UTI therapy (CRP: standardized mean difference [SMD] = 3.26, 95% confidence interval [CI] = 1.69-4.83, p < 0.001; IL-6: SMD = 5.92, 95% CI = 2.09-9.75, p = 0.002; TNF-α: SMD = 4.07, 95% CI = 0.79-7.35, p = 0.015). CONCLUSION The results of this meta-analysis suggest that UTI can effectively depress the serum levels of CRP, IL-6, and TNF-α in Asian patients with AP, and thereby inhibit inflammation.
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Affiliation(s)
- Chunze Zhang
- 1 Department of Colorectal Surgery, Tianjin Union Medicine Centre , Tianjin, P.R. China
| | - Yijia Wang
- 2 Department of Pathology, Tianjin Union Medicine Centre , Tianjin, P.R. China
| | - Wenzheng Fu
- 1 Department of Colorectal Surgery, Tianjin Union Medicine Centre , Tianjin, P.R. China
| | - Weihua Zhang
- 1 Department of Colorectal Surgery, Tianjin Union Medicine Centre , Tianjin, P.R. China
| | - Tao Wang
- 1 Department of Colorectal Surgery, Tianjin Union Medicine Centre , Tianjin, P.R. China
| | - Hai Qin
- 1 Department of Colorectal Surgery, Tianjin Union Medicine Centre , Tianjin, P.R. China
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Protective effects of Acanthopanax vs. Ulinastatin against severe acute pancreatitis-induced brain injury in rats. Int Immunopharmacol 2015; 24:285-298. [DOI: 10.1016/j.intimp.2014.12.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/08/2014] [Accepted: 12/09/2014] [Indexed: 12/20/2022]
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Liu R, Qi H, Wang J, Wang Y, Cui L, Wen Y, Yin C. Ulinastatin activates the renin-angiotensin system to ameliorate the pathophysiology of severe acute pancreatitis. J Gastroenterol Hepatol 2014; 29:1328-37. [PMID: 24628092 DOI: 10.1111/jgh.12584] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND AIM Ulinastatin is a drug used effectively to alleviate symptoms and improve the pathophysiology of various types of pancreatitis. However, the molecular mechanism responsible for its action remains unknown. Therefore, we further explore the therapeutic effects of ulinastatin and investigate possible molecular pathways modulated by this drug in the development of severe acute pancreatitis (SAP). METHODS SAP mouse model was created by administering intraperitoneal injections of cerulein and lipopolysaccharide. Pancreatic injury was assessed by performing biochemical and histological assays and by measuring the inflammatory response of the pancreas. Specifically, we examined changes in the expression of components of the rennin-angiotensin system (RAS), including angiotensin-converting enzyme (ACE)-angiotensin II (Ang II)-angiotensin type 1 receptor (AT-1R), and ACE2-Ang-(1-7)-Mas receptor. RESULTS When SAP mouse models were treated with ulinastatin at a dosage of 50,000 U/kg body weight, we found, through biochemical and histopathological analyses, that the pancreatic injury was significantly ameliorated. Administration of ulinastatin to SAP mice led to increased expression of ACE2, Ang-(1-7), and Mas receptor, decreased expression of serum Ang II and pancreatic AT-1R, and no alterations in the expression of pancreatic ACE and Ang II when compared to cerulein-treated control group that did not receive ulinastatin. CONCLUSIONS This study shows that ulinastatin has differential effects on the two axes of the RAS during SAP. Our results further suggest that upregulation of components of the ACE2-Ang-(1-7)-Mas pathway might be an important mechanism contributing to the therapeutic role of ulinastatin in alleviating pancreatitis-associated symptoms.
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Affiliation(s)
- Ruixia Liu
- Department of Infection, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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The effect of somatostatin, ulinastatin and Salvia miltiorrhiza on severe acute pancreatitis treatment. Am J Med Sci 2014; 346:371-6. [PMID: 23514667 DOI: 10.1097/maj.0b013e31827aa2bc] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the efficacy of somatostatin, ulinastatin and Salvia miltiorrhiza for treatment of severe acute pancreatitis. METHODS Three hundred six patients with severe acute pancreatitis were divided randomly into 5 groups: basic treatment, somatostatin, somatostatin + ulinastatin, somatostatin + S miltiorrhiza and somatostatin + ulinastatin + S miltiorrhiza. Amount of time for resolution of abdominal pain/distention, recovery to normal heart and respiratory rates, amylase and blood glucose levels, Acute Physiology and Chronic Health Evaluation II scores, and levels of tumor necrosis factor-α, interleukin (IL)-6, and IL-10 were analyzed and recorded for all 5 subgroups. RESULTS Tumor necrosis factor-α and IL-6 levels on the fourth and seventh days, and Acute Physiology and Chronic Health Evaluation II scores on the seventh day after treatment showed significant decrease in the somatostatin, somatostatin + ulinastatin, somatostatin + S miltiorrhiza and somatostatin + ulinastatin + S miltiorrhiza subgroups compared with the basic treatment subgroup. IL-10 levels on the fourth and seventh days were significantly improved in the somatostatin + ulinastatin, somatostatin + S miltiorrhiza and somatostatin + ulinastatin + S miltiorrhiza subgroups compared with the basic treatment subgroup. The incidences of pancreatic sepsis, multiple organ dysfunction syndrome and mortality were lower in the somatostatin, somatostatin + ulinastatin, somatostatin + S miltiorrhiza and somatostatin + ulinastatin + S miltiorrhiza subgroups compared with the basic treatment subgroup. CONCLUSIONS Somatostatin is effective for the treatment of acute pancreatitis and both ulinastatin and S miltiorrhiza demonstrate improvement in therapeutic benefits.
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Chen S, Shi H, Zou X, Luo H. Role of ulinastatin in preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: the Emperor's New Clothes or Aladdin's Magic Lamp? Pancreas 2010; 39:1231-1237. [PMID: 20531245 DOI: 10.1097/mpa.0b013e3181dc67e7] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The role of prophylactic ulinastatin in the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis is debated. A meta-analysis of all published randomized clinical trials was performed to evaluate the efficacy of ulinastatin on post-ERCP pancreatitis. METHODS Searches were conducted in multiple databases composed of PubMed, EMBASE, the Cochrane Library, the Science Citation Index Expanded, and the China National Knowledge Infrastructure series full-text database. Primary outcome was post-ERCP pancreatitis, with or without hyperamylasemia. RESULTS Seven randomized clinical trials fulfilling the inclusion criteria were selected for meta-analysis, 5 comparing ulinastatin with placebo and 2 for ulinastatin versus gabexate. The incidence of post-ERCP pancreatitis was reduced by ulinastatin (odds ratio, 0.53; 95% confidence interval, 0.31-0.89; P = 0.02; test for heterogeneity: I = 0%; P = 0.51), so was the event of hyperamylasemia (odds ratio, 0.42; 95% confidence interval, 0.30-0.59; P < 0.00001; test for heterogeneity: I = 13%; P = 0.33). Subsequent sensitivity and subgroup analyses produced conflicting results. CONCLUSIONS Ulinastatin shows to be of value on preventing post-ERCP pancreatitis and hyperamylasemia for patients in average risk, when given intravenously at a dose of not less than 150,000 U, just before ERCP. More high-quality trials are needed for further confirmation.
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Affiliation(s)
- SuYu Chen
- Department of Gastroenterology, First Affiliated Medical College of Wuhan University, Renmin Hospital of Wuhan University, Whuhan, China
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Zhang XP, Chen HQ, Liu F, Zhang J. Advances in researches on the immune dysregulation and therapy of severe acute pancreatitis. J Zhejiang Univ Sci B 2009; 10:493-8. [PMID: 19585666 PMCID: PMC2704966 DOI: 10.1631/jzus.b0820265] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2008] [Accepted: 05/05/2009] [Indexed: 12/20/2022]
Abstract
During the development and progression of severe acute pancreatitis (SAP), conspicuous immune dysregulation develops, which is mainly manifested as excessive immune response in the early stage and immunosuppression in the late stage. This process involves complex changes in a variety of immune molecules and cells, such as cytokines, complements, lymphocytes, and leukocytes. With the gradual deepening of studies on the development and progression of SAP, the role of immune dysregulation in the pathogenesis of SAP has attracted more and more attention. In this article, we review the advances in research on the immune dysregulation in SAP and the immunotherapy of this disease through exploring the formation of excessive immune response and immune suppression as well as their mutual transformation.
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Affiliation(s)
- Xi-Ping Zhang
- Department of General Surgery, Hangzhou First People's Hospital, Hangzhou 310006, China.
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Zhao LM, Feng ZJ. Medical treatment of severe acute pancreatitis with multiple organ dysfunction syndrome. Shijie Huaren Xiaohua Zazhi 2009; 17:1061-1068. [DOI: 10.11569/wcjd.v17.i11.1061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Severe acute pancreatitis (SAP) is one of the crucial acute abdominal diseases. Multiple organ dysfunction syndromes (MODS) is the main cause of death in SAP patients. The medical treatment measures include the fundamental cure such as fluid resuscitation, correction of the internal environment disorder and hyoxemia, and preferred application of somatostatin, adequate use of trypsin inhibitors, antibiotics and early enteral nutrition. In addition, immunomodulation, antioxidants, blood purification and endoscopic interventional therapy may be selective to improve the prognosis of SAP.
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Bao P, Gao W, Li S, Zhang L, Qu S, Wu C, Qi H. Effect of pretreatment with high-dose ulinastatin in preventing radiation-induced pulmonary injury in rats. Eur J Pharmacol 2008; 603:114-9. [PMID: 19101537 DOI: 10.1016/j.ejphar.2008.12.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Revised: 11/18/2008] [Accepted: 12/01/2008] [Indexed: 10/21/2022]
Abstract
In order to develop a better management strategy for radiation-induced pulmonary injury, we compared the protective effect of pretreatment and aftertreatment with different doses of ulinastatin. Two hundred and forty female Sprague-Dawley rats were randomized into five groups. Group R received radiation only, groups P1 and P2 were pretreated with different doses of i.v. ulinastatin for 3 days pre- and 4 days post-irradiation, and groups A1 and A2 were treated for 7 days post-irradiation only. Rats were sacrificed at 2 h, and at 4, 8, 16, and 24 weeks post-irradiation. The expressions of TGF-beta1, TNF-alpha, IL-6, hydroxyproline and laminin were determined. No adverse toxicological effects of ulinastatin pretreatment were observed. Mortality and ratio of fibrotic area was lowest in group P1(5/45; 30.6+/-3.11%, P<0.05 vs. A2). Expressions of TGF-beta1 and IL-6 in group P1 were significantly lowest at 4 weeks (3.01+/-0.35, 549+/-58, 32.3+/-3.27, P<0.01), and expressions of hydroxyproline and laminin were also lowest at 24 weeks (741+/-68 and 82.6+/-6.91, P<0.01) in comparison with other groups. Significant differences were observed in expression of TGF-beta1 and TNF-alpha in lung between group P1 and group A1 at 4 weeks (263+/-11% vs. and 187+/-9%, 189+/-8% vs. 154+/-9%, P<0.01, P<0.05 respectively). Pretreatment with high dose ulinastatin resulted in a milder inflammatory response and suppressed pulmonary fibrosis, which may serve as a favorable management strategy.
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Affiliation(s)
- Pengtao Bao
- Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, PR China.
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