Skip to main content
Annals of Surgery logoLink to Annals of Surgery
. 1989 Dec;210(6):740–747. doi: 10.1097/00000658-198912000-00008

Neutrophil-dependent, oxygen-radical mediated lung injury associated with acute pancreatitis.

K S Guice 1, K T Oldham 1, M G Caty 1, K J Johnson 1, P A Ward 1
PMCID: PMC1357865  PMID: 2589887

Abstract

Cerulein-induced acute pancreatitis in rats is associated with a reversible lung injury that is characterized by alveolar capillary endothelial-cell injury, increased microvascular permeability, interstitial edema formation, and intraalveolar hemorrhage and fibrin deposition. The role of mediators in this injury was analyzed using gravimetric data, microvascular permeability indices, electron microscopy, and a quantitative morphometric analysis. Neutrophil depletion induced by a specific antibody was highly protective against lung injury. Interruption of the complement pathway (using low dose Naja naja cobra venom factor) also protected against lung injury. Catalase and superoxide dismutase were also protective. The iron chelator deferoxamine and the hydroxyl radical scavenger, dimethylsulfoxide, were not protective against acute lung injury. These data suggest that complement, neutrophils, and neutrophil-derived (H2O2-dependent) oxygen products mediate lung injury that occurs secondary to cerulein-induced pancreatitis. In contrast to other models of neutrophil-dependent, oxygen-radical-mediated lung injury, this lung injury does not appear to be an iron-dependent and hydroxyl-radical mediated injury. We postulate that the process of acute pancreatitis leads to complement activation followed by neutrophil recruitment, sequestration, and adherence to alveolar capillary endothelial cells. Ultimately lung injury appears to result from local endothelial-cell injury secondary to neutrophil-generated oxygen products that may be myeloperoxidase dependent.

Full text

PDF
740

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allan G., Bhattacherjee P., Brook C. D., Read N. G., Parke A. J. Myeloperoxidase activity as a quantitative marker of polymorphonuclear leukocyte accumulation into an experimental myocardial infarct--the effect of ibuprofen on infarct size and polymorphonuclear leukocyte accumulation. J Cardiovasc Pharmacol. 1985 Nov-Dec;7(6):1154–1160. doi: 10.1097/00005344-198511000-00022. [DOI] [PubMed] [Google Scholar]
  2. Ballow M., Cochrane C. G. Two anticomplementary factors in cobra venom: hemolysis of guinea pig erythrocytes by one of them. J Immunol. 1969 Nov;103(5):944–952. [PubMed] [Google Scholar]
  3. Bradley P. P., Priebat D. A., Christensen R. D., Rothstein G. Measurement of cutaneous inflammation: estimation of neutrophil content with an enzyme marker. J Invest Dermatol. 1982 Mar;78(3):206–209. doi: 10.1111/1523-1747.ep12506462. [DOI] [PubMed] [Google Scholar]
  4. Guice K. S., Oldham K. T., Johnson K. J. Failure of antioxidant therapy (polyethylene glycol-conjugated catalase) in acute pancreatitis. Am J Surg. 1989 Jan;157(1):145–149. doi: 10.1016/0002-9610(89)90437-6. [DOI] [PubMed] [Google Scholar]
  5. Guice K. S., Oldham K. T., Johnson K. J., Kunkel R. G., Morganroth M. L., Ward P. A. Pancreatitis-induced acute lung injury. An ARDS model. Ann Surg. 1988 Jul;208(1):71–77. doi: 10.1097/00000658-198807000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Imrie C. W., Ferguson J. C., Murphy D., Blumgart L. H. Arterial hypoxia in acute pancreatitis. Br J Surg. 1977 Mar;64(3):185–188. doi: 10.1002/bjs.1800640310. [DOI] [PubMed] [Google Scholar]
  7. Interiano B., Stuard I. D., Hyde R. W. Acute respiratory distress syndrome in pancreatitis. Ann Intern Med. 1972 Dec;77(6):923–926. doi: 10.7326/0003-4819-77-6-923. [DOI] [PubMed] [Google Scholar]
  8. Johnson K. J., Wilson B. S., Till G. O., Ward P. A. Acute lung injury in rat caused by immunoglobulin A immune complexes. J Clin Invest. 1984 Aug;74(2):358–369. doi: 10.1172/JCI111431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lampel M., Kern H. F. Acute interstitial pancreatitis in the rat induced by excessive doses of a pancreatic secretagogue. Virchows Arch A Pathol Anat Histol. 1977 Mar 11;373(2):97–117. doi: 10.1007/BF00432156. [DOI] [PubMed] [Google Scholar]
  10. Lankisch P. G., Rahlf G., Koop H. Pulmonary complications in fatal acute hemorrhagic pancreatitis. Dig Dis Sci. 1983 Feb;28(2):110–116. doi: 10.1007/BF01315139. [DOI] [PubMed] [Google Scholar]
  11. Magnuson D. K., Maier R. V., Pohlman T. H. Protein kinase C: a potential pathway of endothelial cell activation by endotoxin, tumor necrosis factor, and interleukin-1. Surgery. 1989 Aug;106(2):216–223. [PubMed] [Google Scholar]
  12. Ranson J. H., Roses D. F., Fink S. D. Early respiratory insufficiency in acute pancreatitis. Ann Surg. 1973 Jul;178(1):75–79. doi: 10.1097/00000658-197307000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Renner I. G., Savage W. T., 3rd, Pantoja J. L., Renner V. J. Death due to acute pancreatitis. A retrospective analysis of 405 autopsy cases. Dig Dis Sci. 1985 Oct;30(10):1005–1018. doi: 10.1007/BF01308298. [DOI] [PubMed] [Google Scholar]
  14. Shihabi Z. K., Bishop C. Simplified turbidimetric assay for lipase activity. Clin Chem. 1971 Dec;17(12):1150–1153. [PubMed] [Google Scholar]
  15. Till G. O., Beauchamp C., Menapace D., Tourtellotte W., Jr, Kunkel R., Johnson K. J., Ward P. A. Oxygen radical dependent lung damage following thermal injury of rat skin. J Trauma. 1983 Apr;23(4):269–277. doi: 10.1097/00005373-198304000-00001. [DOI] [PubMed] [Google Scholar]
  16. Till G. O., Johnson K. J., Kunkel R., Ward P. A. Intravascular activation of complement and acute lung injury. Dependency on neutrophils and toxic oxygen metabolites. J Clin Invest. 1982 May;69(5):1126–1135. doi: 10.1172/JCI110548. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Varani J., Fligiel S. E., Till G. O., Kunkel R. G., Ryan U. S., Ward P. A. Pulmonary endothelial cell killing by human neutrophils. Possible involvement of hydroxyl radical. Lab Invest. 1985 Dec;53(6):656–663. [PubMed] [Google Scholar]
  18. Verduin P. A., Punt J. M., Kreutzer H. H. Studies on the determination of lipase activity. Clin Chim Acta. 1973 Jun 14;46(1):11–19. doi: 10.1016/0009-8981(73)90096-x. [DOI] [PubMed] [Google Scholar]
  19. Warshaw A. L., Lesser P. B., Rie M., Cullen D. J. The pathogenesis of pulmonary edema in acute pancreatitis. Ann Surg. 1975 Oct;182(4):505–510. doi: 10.1097/00000658-197510000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES