Effects of infliximab on bacterial translocation in experimental acute necrotizing pancreatitis
Sezai Aydin1, A Turan Isik2, Bulent Unal3, Bilgin Comert4, Mustafa Ozyurt5, Salih Deveci6, Gokhan Ozgur7, Omer Cengiz8, Ilker Tasci7, M Refik Mas9
1 Department of Surgery, Guven Hospital, A. Ayranci, Ankara, Turkey
2 Department of Internal Medicine, Geriatric Division, Bezmialem Vakif University, Istanbul, Turkey
3 Department of Surgery, University of Inonu, Malatya, Turkey
4 Department of Internal Medicine, Intenstive Care Division, Dokuz Eylül, University, School of Medicine, Izmir, Turkey
5 Department of Microbiology, Gulhane School of Medicine, Istanbul, Turkey
6 Department of Pathology, Gulhane School of Medicine, Ankara, Turkey
7 Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey
8 Department of Surgery, Numune Training Hospital, Ankara, Turkey
9 Department of Internal Medicine, Geriatric Division, Dokuz Eylül University, School of Medicine, Izmir, Turkey
M Refik Mas
Department of Internal Medicine & Geriatrics, Dokuz Eylül University, Faculty of Medicine, Balcova, 35340, Izmir
Source of Support: None, Conflict of Interest: None
Background & objectives: Translocation of bacteria from the gut is an important factor in the development of septic complications and mortality in acute pancreatitis (AP). The present study was designed to assess the effects of infliximab treatment on bacterial translocation (BT) in experimental acute necrotizing pancreatitis.
Methods: Male Sprague-Dawley rats (n=45) were allocated into three groups. AP was induced in group II (positive control, n=15) and group III (Infliximab; n=15) by retrograde injection of taurocholate into the common biliopancreatic duct. Group I rats (Sham; n=15) received normal saline infusion into the common biliopancreatic duct as placebo. Groups I and II were treated by normal saline and group III was treated with infliximab intraperitoneally on 6, 30 and 54 h after induction of pancreatitis. All surviving animals were killed 60 h after the induction of pancreatitis, and specimens were collected for amylase measurement as well as histopathologic and microbiologic examinations.
Results: Oedema, acinar cell necrosis, inflammatory infiltration, haemorrhage, fat necrosis and perivascular inflammation in group III rats were decreased with infliximab treatment when compared with group II (P<0.001). BT to mesentery lymph node in groups I, II and III were 20, 100 and 46 per cent, respectively. BT to peritoneum and pancreas in group III was lower than group II (P<0.05).
Interpretation & conclusions: Infliximab administration resulted in beneficial effects on BT and histopathologic changes in the experimental necrotizing pancreatitis. Whether anti-TNF therapy has a role in prevention of complications of ANP needs to be established.