Skip to main content

Immunomodulatory Treatment of Severe Acute Pancreatitis

  • Chapter
Intensive Care Medicine

Abstract

Severe acute pancreatitis is characterized by multiple-system organ failure (MOF) that emerges early after onset of disease, and local complications, in particular pancreatic infection, that usually supervene later in the course of the attack.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Beger HG, Bittner R, Block S, Büchler M (1986) Bacterial contamination of pancreatic necrosis. A prospective clinical study. Gastroenterology 91: 433–438

    Google Scholar 

  2. Rinderknecht H (1988) Fatal pancreatitis, a consequence of excessive leukocyte stimulation? Int J Pancreatol 3: 105–112

    PubMed  CAS  Google Scholar 

  3. Büchler M, Malfertheiner P, Uhl W, et al (1993) Gabexate mesilate in human acute pancreatitis. Gastroenterology 104: 1165–1170

    PubMed  Google Scholar 

  4. Norman J, Fink G, Denham W, et al (1997) Tissue specific cytokine production during experimental acute pancreatitis: a probable mechanism for distant organ dysfunction. Dig Dis Sci 42: 1783–1788

    Article  PubMed  CAS  Google Scholar 

  5. Fink GW, Norman J (1996) Intrapancreatic interleukin 1 gene expression by specific leukocyte populations during acute pancreatitis. J Surg Res 63: 369–373

    Article  PubMed  CAS  Google Scholar 

  6. Grewal HP, Kotb M, Mohey El din A, et al (1994) Induction of tumor necrosis factor in severe acute pancreatitis and its subsequent reduction after hepatic passage. Surgery 115: 213–221

    PubMed  CAS  Google Scholar 

  7. Werner J, Dragotakes S, Fernandez-del Castillo C, et al (1998) Technetium-99m-labeled white blood cells: a new method to define the local and systemic role of leukocytes in acute experimental pancreatitis. Ann Surg 227: 86–94

    Article  PubMed  CAS  Google Scholar 

  8. Gukovskaya AS, Gukovsky I, Zaninovic V, Song M, Sandoval D, Gukovsky S (1997) Pancreatic acinar cells produce, release and respond to tumor necrosis factor-alpha. Role in regulating cell death and pancreatitis. J Clin Invest 100: 1853–1862

    Google Scholar 

  9. Yang B, Demaine A, Kingsnorth A (2000) Chemokines MCP-1 and RANTES in isolated rat pancreatic acinar cells treated with CCK and ethanol in vitro. Pancreas 21: 22–31

    Article  PubMed  CAS  Google Scholar 

  10. Sandoval D, Gukovskaya A, Reavey P, et al (1996) The role of neutrophils and platelet-activating factor in mediating experimental pancreatitis. Gastroenterology 111: 1081–1091

    Article  PubMed  CAS  Google Scholar 

  11. Telek G, Ducroc R, Scoazec J-Y, Pasquier C, Feldmann G, Rozé C (2001) Differential up-regulation of cellular adhesion molecules at the sites of oxidative stress in experimental acute pancreatitis. J Surg Res 96: 56–67

    Article  PubMed  CAS  Google Scholar 

  12. Osman MO, Kristensen JU, Jacobsen N, et al (1998) A monoclonal anti-interleukin 8 antibody (WS-4) inhibits cytokine response and acute lung injury in experimental severe acute necrotising pancreatitis in rabbits. Gut 43: 232–239

    Article  PubMed  CAS  Google Scholar 

  13. Denham W, Yang J, Fink G, et al (1998) TNF but not IL-I decreases pancreatic acinar cell survival without affecting exocrine function; a study in the perfused human pancreas. J Surg Res 74: 3–7

    Article  PubMed  CAS  Google Scholar 

  14. Malaka D, Vasseur S, Bödeker H, et al (2000) Tumor necrosis factor alpha triggers antiapoptotic mechanisms in rat pancreatic cells trough pancreatitis=associated protein I activation. Gastroenterology 119: 816–828

    Article  Google Scholar 

  15. Bathia M, Wallig MA, Hofbauer B, et al (1998) Induction of apoptosis in pancreatic acinar cells reduces the severity of acute pancreatitis. Biochem Biophys Res Corn 19: 476–483

    Google Scholar 

  16. Eubanks JW, Sabek 0, Kotb M, et al (1998) Acute pancreatitis induces cytokine production in endotoxin-resistant mice. Ann Surg 227: 904–911

    Article  PubMed  Google Scholar 

  17. Gukovsky I, Gukovskaya A, Blinman T, Zaninovic V, Pandol S (1998) Early NF-KB activation is associated with hormone-induced pancreatitis. Am J Physiol 275: G1402–G1414

    PubMed  CAS  Google Scholar 

  18. Tsai K, Wang SS, Chen TS, et al (1998) Oxidative stress: an important phenomenon with pathogenetic significance in the progression of acute pancreatitis. Gut 42: 850–855

    Article  PubMed  CAS  Google Scholar 

  19. Lundberg A, Eubanks J, Henry J, et al (2000) Trypsin stimulates production of cytokines from peritoneal macrophages in vitro and in vivo. Pancreas 21: 41–51

    Article  PubMed  CAS  Google Scholar 

  20. Jaffray C, Mendez C, Denham W, Carter G, Norman J (2000) Specific pancreatic enzymes activate macrophages to produce tumor necrosis factor-alpha: role of nuclear factor Kappa B and inhibitory Kappa B proteins. J Gastrointest Surg 4: 370–378

    Article  PubMed  CAS  Google Scholar 

  21. Jaffray C, Yang J, Norman J (2000) Elastase mimics pancreatitis-induced hepatic injury via inflammatory mediators. J Surg Res 90: 95–101

    Article  PubMed  CAS  Google Scholar 

  22. Jaffray C, Yang J, Carter G, Mendez C, Norman J (2000) Pancreatic elastase activates pulmonary nuclear factor kappa B and inhibitory kappa B, mimicking pancreatitis-associated adult respiratory distress syndrome. Surgery 128: 225–231

    Article  PubMed  CAS  Google Scholar 

  23. Denham W, Yang J, Norman J (1997) Evidence for an unknown component of pancreatic ascites that induces adult respiratory distress syndrome through an interleukin-1 and tumor necrosis factor-dependent mechanism. Surgery 122: 295–302

    Article  PubMed  CAS  Google Scholar 

  24. Gloor B, Blinman T, Rigberg D, et al (2000) Kupffer cell blockade reduces hepatic and systemic cytokine levels and lung injury in hemorrhagic pancreatitis in rats. Pancreas 21: 414420

    Google Scholar 

  25. Norman J, Fink G, Messina J, Carter G, Franz M (1996) Timing of tumor necrosis factor antagonism is critical in determining outcome in murine lethal acute pancreatitis. Surgery 120: 515–521

    Article  PubMed  CAS  Google Scholar 

  26. Guice KS, Oldham KT, Rezmick DG, Kunkel SL, Ward PA (1991) Anti-tumor necrosis factor antibody augments edema formation in caerulein-induced acute pancreatitis. J Surg Res 51: 495–499

    Article  PubMed  CAS  Google Scholar 

  27. Denham W, Yang J, Fink G, et al (1997) Gene targeting demonstrates additive detrimental effects of interleukin I and tumor necrosis factor during pancreatitis. Gastroenterology 113: 1741–1746

    Article  PubMed  CAS  Google Scholar 

  28. Hughes CB, El-Din A, Kotb M, Gaber L, Gaber A (1996) Calcium channel blockade inhibits release of TNF alpha and improves survival in a rat model of acute pancreatitis. Pancreas 13: 22–28

    Article  PubMed  CAS  Google Scholar 

  29. Yang J, Denham W, Tracey K, et al (1998) The physiologic consequences of macrophage pacification during severe acute pancreatitis. Shock 10: 169–175

    Article  PubMed  CAS  Google Scholar 

  30. Demols A, Van Laethem J-L, Quertinmont E, et al (1998) N-Acetylcysteine decreases severity of acute pancreatitis in mice. Pancreas 20: 161–169

    Article  Google Scholar 

  31. Imrie CW (1999) The possible role of platelet-activating factor antagonist therapy in the management of severe acute pancreatitis. Bailliere’s Clin Gastroenterol 13: 357–364

    Article  CAS  Google Scholar 

  32. Gerard C, Frossard J-L, Bhatia M, et al (1997) Targeted disruption of the B-chemokine receptor CCRI protects against pancreatitis-associated lung injury. J Clin Invest 100: 20222027

    Google Scholar 

  33. Frossard JL, Saluja A, Bhagat L, et al (1999) The role of intercellular adhesion molecule 1 and neutrophils in acute pancreatitis and pancreatitis-associated lung injury. Gastroenterology 116: 694–701

    Article  PubMed  CAS  Google Scholar 

  34. de Beaux AC, Goldie AS, Ross JA, Carter DC, Fearon KC (1996) Serum concentrations of inflammatory mediators related to organ failure in patients with acute pancreatitis. Br J Surg 83: 349–353

    Article  PubMed  Google Scholar 

  35. Gross V, Andreesen R, Leser HG, et al (1992) Interleukin-8 and neutrophil activation in acute pancreatitis. Eur J Clin Invest 22: 200–203

    Article  PubMed  CAS  Google Scholar 

  36. Hietaranta A, Kemppainen E, Puolakkainen P, et al (1999) Extracellular phospholipases A2 in relation to systemic inflammatory response syndrome ( SIRS) and systemic complications in severe acute pancreatitis. Pancreas 18: 385–391

    Google Scholar 

  37. Schölmerich J, Schümichen C, Lausen M, et al (1991) Scintigraphic assessment of leukocyte infiltration in acute pancreatitis using technetium-99m-hexamethyl propylene amine oxine as leukocyte label. Dig Dis Sci 36: 65–71

    Article  PubMed  Google Scholar 

  38. Hynninen M, Valtonen M, Markkanen H, et al (1999) Interleukin 1 receptor antagonist and E-selectin concentrations: a comparison in patients with severe acute pancreatitis and severe sepsis. J Crit Care 14: 63–68

    Article  PubMed  CAS  Google Scholar 

  39. Kaufmann P, Smolle K, Brunner G, Demel U, Tilz G, Krejs G (1999) Relation of serial measurements of plasma-soluble intercellular adhesion molecule-1 to severity of acute pancreatitis. Am J Gastroenterol 94: 2412–2416

    Article  PubMed  CAS  Google Scholar 

  40. de Beaux AC, Ross JA, Maingay JP, Fearon KC, Carter DC (1996) Proinflammatory cytokine release by peripheral blood mononuclear cells from patients with acute pancreatitis. Br J Surg 83: 1071–1075

    Article  PubMed  Google Scholar 

  41. Brivet F, Emilie D, Galanaud P, et al (1999). Pro-and anti-inflammatory cytokines during acute severe pancreatitis: an early and sustained response, although unpredictable of death. Crit Care Med 27: 749–755

    Article  PubMed  CAS  Google Scholar 

  42. Messmann H, Vogt W, Falk W, et al (1998) Interleukins and their antagonists but not TNF and its receptors are released in post-ERP pancreatitis. Europ J Gastroent Hepatol 10: 611617

    Google Scholar 

  43. McKay CJ, Gallagher G, Brooks B, Imrie CW, Baxter JN (1996) Increased monocyte cytokine production in association with systemic complications in acute pancreatitis. Br J Surg 83: 919–923

    Article  PubMed  CAS  Google Scholar 

  44. Montravers P, Chollet-Martin S, Marmuse JP, Gougerot-Picidalo MA, Desmonts JM (1995) Lymphatic release of cytokines during acute lung injury complicating severe pancreatitis. Am J Respir Crit Care Med 152: 1527–1533

    Article  PubMed  CAS  Google Scholar 

  45. Mayer J, Rau B, Gansauger F, Beger H (2000) Inflammatory mediators in human acute pancreatitis; clinical and pathophysiological implications. Gut 47: 546–552

    Article  PubMed  CAS  Google Scholar 

  46. Kaufmann P, Tilz G, Lueger A, Demel U (1997) Elevated plasma levels of soluble tumor necrosis factor receptor (sTNFRp60) reflect severity of acute pancreatitis. Intensive Care Med 23: 841–848

    Article  PubMed  CAS  Google Scholar 

  47. Devière J, Le Moine 0, Van Laethem J-L, et al (2001) Interleukin 10 reduces the incidence of pancreatitis after therapeutic endoscopic retrograde cholangiopancreatography. Gastroenterology 120: 498–505

    Article  PubMed  Google Scholar 

  48. Johnson C, Kingsnorth A, Imrie C, et al (2001) Double blind, randomised, placebo controlled study of a platelet activating factor antagonist, lexipafant, in the treatment and prevention of organ failure in predicted severe acute pancreatitis. Gut 48: 62–69

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer Science+Business Media New York

About this chapter

Cite this chapter

Dugernier, T., Reynaert, M.S., Laterre, P.F. (2002). Immunomodulatory Treatment of Severe Acute Pancreatitis. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-5551-0_70

Download citation

  • DOI: https://doi.org/10.1007/978-1-4757-5551-0_70

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4757-5553-4

  • Online ISBN: 978-1-4757-5551-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics