Nitric oxide synthase inhibition reduces albumin induced lung damage in acute pancreatitis.

Abstract

BACKGROUND/OBJECTIVES:

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).

CONCLUSION:

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: Emilio Elias Abdo, Ana Maria Mendonça Coelho, Rosely Antunes Patzina, Sandra Nassa Sampietre, José Eduardo Monteiro Cunha, Marcel Cerqueira Cesar Machado, Luiz Augusto Carneiro D'Albuquerque
• Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] (Pancreatology) 2013 May-Jun Vol. 13 Issue 3 Pg. 225-9 ISSN: 1424-3911 [Electronic] Switzerland
• PMID: 23719592 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Chemical References

• Albumins
• Isothiuronium
• Taurocholic Acid
• Peroxidase
• Nitric Oxide Synthase Type II
• Nos2 protein, rat
• Amylases
• S-methylisothiopseudouronium

Topics

• Albumins (adverse effects)
• Amylases (blood, drug effects)
• Animals
• Capillary Permeability (drug effects)
• Isothiuronium (analogs & derivatives, therapeutic use)
• Lung (drug effects, pathology)
• Nitric Oxide Synthase Type II (antagonists & inhibitors)
• Pancreatitis (chemically induced, drug therapy, physiopathology)
• Peroxidase
• Rats
• Rats, Wistar
• Taurocholic Acid