Effect of APD on pancreatic apoptosis in rats with severe acute pancreatitis / 解放军医学杂志

ABSTRACT

Objective To investigate the effect of abdominal paracentesis drainage (APD) on pancreatic cell apoptosis in severe acute pancreatitis. Methods Male adult SD rats were randomized into the sham operation (SO) group, SAP group, and APD group, with 18 rats in each group. In the SAP group, 5% sodium sulfonate was pumped into the retrograde pancreatic bile duct to prepare the SAP model. On this basis, a gastric tube was introduced into the right lower abdomen for drainage, namely the APD group. Blood from the abdominal aorta and pancreatic tissues were collected at 6, 12, and 24 h time points in each group. The changes of serum amylase, inflammatory factor, and endotoxin were detected by ELISA. The HE staining was used to evaluate the pancreatic tissue injury. The apoptosis of pancreatic tissue was detected by TUNEL. Western blot and immunohistochemistry were used to detect the expression of apoptosis-related proteins and PI3K/AKT signaling pathway. Results Pancreatic tissue necrosis and edema were significantly lower in the APD group than in the SAP group, and the pathological score was decreased (P<0.05). Serum amylase, TNF-α, IL-1β, IL-6, and endotoxin levels in the APD group were significantly lower than those in the SAP group (P<0.05). The number of pancreatic cell apoptosis in the APD group was significantly higher than that in the SAP group (P<0.05), and the expression levels of pancreatic apoptotic proteins cleaved-caspase-3 and Bax were significantly increased in the APD group, while the expression levels of anti-apoptotic protein Bcl-2 were significantly decreased (P<0.05). Compared with the SAP group, the expression levels of PI3K/AKT signaling pathway key molecules p-PI3K, p-AKT, and NF-kB p65 were significantly decreased in the APD group (P<0.05). Conclusions Our data indicate that APD attenuates the severity of SAP by enhancing cell apoptosis via suppressing PI3K/AKT signaling pathway. This study provides a new theoretical basis for the treatment of severe acute pancreatitis with APD technology.