Abstract

BackgroundIn severe acute pancreatitis (AP) the CNS is affected manifesting in neurological symptoms. Earlier research from our laboratory showed blood–brain barrier (BBB) permeability elevation in a taurocholate-induced AP model. Here we aimed to further explore BBB changes in AP using a different, non-invasive in vivo model induced by l-ornithine. Our goal was also to identify whether l-ornithine, a cationic amino acid, has a direct effect on brain endothelial cells in vitro contributing to the observed BBB changes.MethodsAP was induced in rats by the intraperitoneal administration of l-ornithine-HCl. Vessel permeability and the gene expression of the primary transporter of l-ornithine, cationic amino acid transporter-1 (Cat-1) in the brain cortex, pancreas, liver and lung were determined. Ultrastructural changes were followed by transmission electron microscopy. The direct effect of l-ornithine was tested on primary rat brain endothelial cells and a triple co-culture model of the BBB. Viability and barrier integrity, including permeability and TEER, nitrogen monoxide (NO) and reactive oxygen species (ROS) production and NF-κB translocation were measured. Fluorescent staining for claudin-5, occludin, ZO-1, β-catenin, cell adhesion molecules Icam-1 and Vcam-1 and mitochondria was performed. Cell surface charge was measured by laser Doppler velocimetry.ResultsIn the l-ornithine-induced AP model vessel permeability for fluorescein and Cat-1 expression levels were elevated in the brain cortex and pancreas. On the ultrastructural level surface glycocalyx and mitochondrial damage, tight junction and basal membrane alterations, and glial edema were observed. l-ornithine decreased cell impedance and elevated the BBB model permeability in vitro. Discontinuity in the surface glycocalyx labeling and immunostaining of junctional proteins, cytoplasmic redistribution of ZO-1 and β-catenin, and elevation of Vcam-1 expression were measured. ROS production was increased and mitochondrial network was damaged without NF-κB, NO production or mitochondrial membrane potential alterations. Similar ultrastructural changes were seen in l-ornithine treated brain endothelial cells as in vivo. The basal negative zeta potential of brain endothelial cells became more positive after l-ornithine treatment.ConclusionWe demonstrated BBB damage in the l-ornithine-induced rat AP model suggesting a general, AP model independent effect. l-ornithine induced oxidative stress, decreased barrier integrity and altered BBB morphology in a culture BBB model. These data suggest a direct effect of the cationic l-ornithine on brain endothelium. Endothelial surface glycocalyx injury was revealed both in vivo and in vitro, as an additional novel component of the BBB-related pathological changes in AP.

Highlights

  • Acute pancreatitis (AP) is a serious gastroenterological inflammatory disease with a high mortality rate [1]

  • Pancreas and brain vessel permeability is elevated in l‐ornithine‐induced acute pancreatitis in rats The permeability of vessels was analyzed in the brain, pancreas, liver and lung (Fig. 1)

  • In the acute pancreatitis (AP) group, the extravasation of sodium fluorescein was significantly elevated in the brain cortex and in the pancreas, while no change was seen for the albumin permeability

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Summary

Introduction

Acute pancreatitis (AP) is a serious gastroenterological inflammatory disease with a high mortality rate [1]. A better understanding of AP and the related comorbidities would improve the disease outcome reducing the rate of organ failure and mortality [4]. The central nervous system (CNS) is affected in 10% of all cases during severe AP leading to pancreatic encephalopathy [7, 8]. Since the mortality rate is 50% among these patients, it is crucial to describe and identify the most important factors and changes leading to this condition [1, 8]. In severe acute pancreatitis (AP) the CNS is affected manifesting in neurological symptoms. We aimed to further explore BBB changes in AP using a different, non-invasive in vivo model induced by l-ornithine. Our goal was to identify whether l-ornithine, a cationic amino acid, has a direct effect on brain endothelial cells in vitro contributing to the observed BBB changes

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