Figure 8.

Possible mechanisms responsible for the protective effects of abdominal paracentesis drainage on severe acute pancreatitis associated cardiac injury. During pancreatitis, high levels of high mobility group box 1 (HMGB1) in the bloodstream can trigger a lethal inflammatory process and participate in the development of remote organ injury. Following abdominal paracentesis drainage treatment, the levels of high mobility group box 1 in the circulation decrease significantly, resulting in inhibition of expression and activity of cardiac nicotinamide adenine dinucleotide phosphate oxidase, thus reactive oxygen species production markedly decreases. These events downregulate expression of caspase-associated proteins and alleviate apoptosis, thereby yielding beneficial effects. HMGB1: High mobility group box 1; APD: Abdominal paracentesis drainage; NOX: Nicotinamide adenine dinucleotide phosphate oxidase; ROS: Reactive oxygen species.