Acute phase response in acute pancreatitis: A comparison with abdominal sepsis

Background: Increased knowledge on the underlying pathophysiological mechanisms in acute pancreatitis (AP) and abdominal sepsis ( AS) is essential, not least for the development of novel ways of treatment. The present study aims at determining dynamic changes in the systemic inflammatory response in AP and AS. Methods: AP was induced by the intraductal injection of sodium taurodeoxycholate in the rat, while AS was induced by caecal ligation and puncture. The animals were killed 1, 3, 6 and 9 h after challenge. Plasma exudation of radiolabelled albumin, myeloperoxidase (MPO), TNF-alpha, MCP-1, superoxide and hydrogen peroxide was measured. Results: Leakage index of human serum albumin showed a significant increase early ( 1 h) after induction of AP and later ( 9 h) in AS compared to controls ( P < 0.05). Hydrogen peroxide generation by circulating monocytes/macrophages was high early ( 1 h) in AP and after 3 and 6 h in AS. Superoxide generation increased by time after both challenges. MPO activity increased significantly, starting at 3 h in both AP and AS ( P < 0.05). TNF-alpha increased significantly at 6 and 9 h in both models. Conclusion: Our results indicate differences in the release of systemic inflammatory mediators and cellular response in AP and AS. However, potential similarities in end-effect, such as the development of remote organ injury ( lungs), may exist as implied by the MPO results. Further investigations of the mechanisms are crucial.