Glutathione In Severe Acute Pancreatitis In The Intestinal Mucosal Barrier Function

Objective:To investigate the protective effect of GSH on intestine barrier functional disturbance induced by severe acute pancreatitis(SAP) and its possible mechanism.Methods:There were Fifty-four Wistar rats weighing(200～260)g with no limitation in sexes. They were randomly divided into three equal groups:sham operation group,SAP group and GSH treatment group.Rats of SAP were induced by retrograde injection of 5%sodium taurocholate into the biliopancreatic duct.GSH treatment groups were given intraperitoneally administrated GSH at a dosage of 0.15g/kg.There were three time points for every group (namely at 6h,12h,24h).Rats in each group were killed after observed at 6h,12h,24h and the serum levels of amylase(AMY),plasma endotoxin(ET) and the expression of MPO in the intestinal mucosa were examined respectively at 6,12,24 hours after operation for each group. Intestinal tissue and pancreas tissue were further pathologied and changes in pathology were observed and evaluated.At the same time,the bacterial culture of samples from pancreas,liver, spleen and mesentery lymph nodes were made respectively and the organs bacterial translocation rate were measured respectively.Results:(1) The serum levels of ET,AMY,the expression of MPO in the intestinal mucosa and the organs bacterial translocation rate in the SAP group at different time points were all significantly higher than those in the GSH group.And SAP group and GSH group were both higher than those in the SO group.(2)There were significantly different about the histological injury degree of pancreatitis and intestine barrier functional disturbance at the different time point.With increasing of intestinal endotoxemia contents,pathological changes of pancreas and intestine were aggravating.The pathological scores of the small intestine and pancreas at the different time points were rising. But after treatment with GSH,the changes became lower than those in SAP group.Conclusion:(1) The high expression of MPO and the serum levels of ET and AMY show it tightly corresponded with severe acute pancreatitis associated intestine barrier dysfunction.The serum levels of plasma endotoxin and the expression of MPO in intestinal mucosa with severe acute pancreatitis associated intestinal barrier dysfunction were important during the disease.(2) The bacterial culture of samples from pancreas,liver,spleen and mesentery lymph nodes were made respectively and changes in pathology indicate that intestinal barrier dysfunction is present in experimental SAP in rats.This probably led to enteric bacterial translocation and endotoxemia.(3) GSH alleviates SAP induced injury to intestinal mucosa and pancreas.It inhibits the releasing of cell factor and mediators of inflammation.It ameliorates enteric bacterial translocation and endotoxemia.It might play a protective role in the intestinal mucosal barrier injury of severe acute pancreatitis.