In acute pancreatitis (AP) the inappropriate activation of pancreatic enzymes plays an important role in pancreas autodigestion and in the inflammatory mechanisms responsible for systemic manifestations of the disease. In a previous study, we have demonstrated that hypertonic saline solution infusion significantly reduces mortality of experimental AP through an improvement in the hemodynamic conditions and possibly by an anti-inflammatory response, but its effects on the pancreatic local lesion were not evaluated.
Aim: To evaluate if the hypertonic saline solution reduces mortality in AP through a local effect attenuating the pancreatic lesion or mainly by reducing the systemic inflammatory response syndrome (SIRS)
Methods: AP was induced in male Wistar rats by intraductal 2.5% taurocholate injection. The animals were divided in 3 groups: NT(n=15): no treated AP, NS (n=15): animals received 34ml/kg of normal saline solution (NaCl 0.9%) IV, 1 hour after AP, and HTS (n=15): animals received 4ml/Kg of hypertonic saline solution (NaCl 7.5%) IV, 1 hour after AP. After 2 and 24 hours of induction of AP ascitic fluid and serum levels of amylase, TAP, TNF-α and IL-6 were determined. Pancreatic histology was also analyzed.
Results: There were no significant differences in amylase and TAP levels in the ascitic fluid and serum in animals of groups NT, NS and HTS (p>0.05). In animals of HTS group a significant decrease of TNF-α and IL-6 levels in the ascitic fluid was observed compared to animals of groups NT and NS (p<0.05). However, both treated groups (NS and HTS) had significantly lower TNF-α and IL-6 serum levels when compared to the NT group (p<0.05). There were no significant differences in histological findings (edema, acinar necrosis, hemorrhage, fat necrosis, and inflammation) in animals of the three groups.
Conclusion: These findings suggest that hypertonic saline solution decreases mortality in acute pancreatitis through the reduction of SIRS and present no beneficial effects on the pancreatic local lesions or on the intensity of enzymatic activity.