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- W2017166446 abstract "Acute pancreatitis is a relatively common and potentially serious complication of ERCP and related interventions. However, its pathogenesis remains poorly understood and attempts at prevention have met with partial success at best. As in other inflammatory states, the transcription factor NF Kappa B (NFkB) is thought to play a key role in the sequence of events leading to the development of pancreatitis. We hypothesized that blocking NFkB activation by intraductal instillation of a potent inhibitor, gliotoxin, may prevent the development of ERCP related pancreatitis. Methods: We studied the effect of intraductal instillation of gliotoxin in a dog model of ECRP induced pancreatitis. In an ongoing study, 6 dogs were randomized in a blinded fashion to receive either placebo or gliotoxin (0.1 mg/kg) intraductally. Pancreatitis was induced by a combination of forceful retrograde injection of contrast material and sphincterotomy as previously described. 24 hours later, dogs were sacrificed, and their pancreata were harvested and graded for histopathological changes of pancreatitis. Results: All dogs survived the experiments for 24 hours. At necropsy, changes of moderate to severe pancreatitis including edema, necrosis, inflammation, vacuolization and hemorrhage were observed in all dogs. Inflammation scores tended to be higher in the gliotoxin group (3.9 versus 3; P = 0.06). Conclusions: These results are consistent with studies of secretagogue induced models of pancreatitis where NFkB activation is felt to induce a self-defending genetic program before the onset of cellular injury, which might prevent higher degrees of damage of pancreatic acinar cells (Gastroenterology 1999; 116:420-430). Our findings suggest that inhibition of NFkB in pancreatitis may have worsened inflammation, thus rendering this an unsuitable strategy for prevention of ERCP induced pancreatitis. Acute pancreatitis is a relatively common and potentially serious complication of ERCP and related interventions. However, its pathogenesis remains poorly understood and attempts at prevention have met with partial success at best. As in other inflammatory states, the transcription factor NF Kappa B (NFkB) is thought to play a key role in the sequence of events leading to the development of pancreatitis. We hypothesized that blocking NFkB activation by intraductal instillation of a potent inhibitor, gliotoxin, may prevent the development of ERCP related pancreatitis. Methods: We studied the effect of intraductal instillation of gliotoxin in a dog model of ECRP induced pancreatitis. In an ongoing study, 6 dogs were randomized in a blinded fashion to receive either placebo or gliotoxin (0.1 mg/kg) intraductally. Pancreatitis was induced by a combination of forceful retrograde injection of contrast material and sphincterotomy as previously described. 24 hours later, dogs were sacrificed, and their pancreata were harvested and graded for histopathological changes of pancreatitis. Results: All dogs survived the experiments for 24 hours. At necropsy, changes of moderate to severe pancreatitis including edema, necrosis, inflammation, vacuolization and hemorrhage were observed in all dogs. Inflammation scores tended to be higher in the gliotoxin group (3.9 versus 3; P = 0.06). Conclusions: These results are consistent with studies of secretagogue induced models of pancreatitis where NFkB activation is felt to induce a self-defending genetic program before the onset of cellular injury, which might prevent higher degrees of damage of pancreatic acinar cells (Gastroenterology 1999; 116:420-430). Our findings suggest that inhibition of NFkB in pancreatitis may have worsened inflammation, thus rendering this an unsuitable strategy for prevention of ERCP induced pancreatitis." @default.
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- W2017166446 date "2000-04-01" @default.
- W2017166446 modified "2023-09-23" @default.
- W2017166446 title "6982 Effects of intraductal instillation of an nfkb inhibitor, gliotoxin, on ercp induced pancreatitis in a dog model." @default.
- W2017166446 doi "https://doi.org/10.1016/s0016-5107(00)14653-x" @default.
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