LOCAL AND SYSTEMIC EFFECTS OF AGING ON ACUTE PANCREATITIS
Marcel C C. Machado*1,2, Ana Maria M. Coelho3, Sandra N. Sampietre3, Fabiano Pinheiro2, José Eduardo M. Cunha3, Luiz C. D'Albuquerque3
1Rua Peixoto Gomide 515, Sao Paulo, SP, Brazil; 2EMERGENCY MEDICINE, FACULDADE DE MEDICINA, SAO PAULO, SAO PAULO, Brazil; 3GASTROENTEROLOGY, University of Sao Paulo, SAO PAULO, Brazil
Background: Acute pancreatitis (AP) in elderly patients in spite of similar occurrence of local complications is followed by a substantial increase in morbidity and mortality rates. Aging process has been found to influence the course and outcome of AP. The mechanisms underlying this age related vulnerability remain unknown. The aim of this study was to evaluate the local and systemic effects of aging on severity of AP in an experimental rat model in elderly animals.
Methods: AP was induced in Wistar rats by intraductal 2.5% taurocholate injection and divided into 2 experimental groups: Young (3 month old) and Aged (18 month old). Two and 24 hours after AP induction blood samples were collected for determinations of amylase, AST, ALT, urea, creatinine, glucose, and of plasma ileal fatty acid binding protein (I-FABP). TNF-α, IL-6 and IL-10 levels were determined in serum and ascitic fluid. Liver mitochondrial function and malondialdehyde (MDA) contents, pancreas histological analysis, and pulmonar myeloperoxidade (MPO) activity were performed. Bacterial translocation was evaluated by bacterial cultures of pancreas expressed in colony-forming units (CFU) per gram.
Results: A significant increase in serum amylase, AST, ALT, urea, creatinine, glucose, I-FABP, and IL-6 levels, and a reduction in serum and ascitic fluid TNF-α levels were observed in the aged group compared to the young group (p<0.05). Serum IL-10 levels were similar in both groups. However, a marked increase in the ratio of IL-10/I-L6 levels was observed in animals of AP young group when compared with animals of AP aged group (p<0.05). Liver mitochondrial dysfunction, MDA contents, and pulmonary MPO activity were increased in the aged AP group compared to the young AP group (p<0.05). A significant increase in positive bacterial cultures and histological analysis obtained from pancreas tissue in aged group was significantly increased compared to the young group (p<0.05).
Conclusions: This study demonstrated that aging influences the course of acute pancreatitis evidenced by increased local and systemic lesions and the increased in bacterial translocation. These findings may have significant therapeutic implication in the clinical setting.
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